By Allan Ruth
An overdose crisis is sweeping New York State and the United States and no medical intervention is as promising at reducing fatalities as buprenorphine and methadone. Also known as medication-assisted treatment, or MAT, they reduce the risk of a fatal overdose for a person who uses opioids by 50 percent.
Fortunately for us in Erie County, most experts and medical providers have embraced MAT. Yet, access to these medications in places where they are needed most is very low.
In local correctional facilities, where people who use drugs are often kept for varying amounts of time for court sanctions and low-level offenses, MAT and transition to it upon release should be a no-brainer. Few members of the general public know this, but the Department of Corrections and Community Supervision is actually the largest treatment provider in the state.
In Erie County, people often speak of only getting a random collection of Motrin, Benadryl and Imodium to cope with severe withdrawal symptoms – a completely inappropriate course of treatment. A friend said to me recently: “I’m a pretty positive guy, but when I was going through withdrawal in jail, I wanted to kill myself. I never thought about that before, but I was that sick.”
Requests for medical attention are often denied, and if your symptoms are persistent, you are suicidal, or deemed disruptive, you are sent to isolation. Isolation means your clothes are taken from you, you are in a small cell alone with only a small slit in the cell door, and other traumas.
People who are prescribed MAT in the community are forced to go off their treatment when in jail or prison. Due to the chemical composition of buprenorphine and methadone, people can experience severe withdrawal even worse than with heroin, and it can last a lot longer.
The fear of withdrawal can drive some people to risk felony charges to bring drugs into the facility with them, knowing they will not get appropriate medical attention.
Sadly, it’s not just the withdrawal one worries about surviving. Because of changes in tolerance, people leaving incarceration are 40 times more likely to die from an overdose within the first two weeks of release.
The reality is that we are treating people who use drugs as lesser and dispensable. Some people are forced to go through this process for low-level offenses, or even when they are awaiting trial. A bill in the state Legislature – Medication Assisted Treatment in the Correctional Setting – is an important step forward for providing lifesaving care in corrections and the transition afterward.
Allan Ruth is an advocate in Buffalo associated with #EndOverdoseNY, a statewide coalition dedicated to ending overdose for all populations.