AMHERST — After researching two local jails, Baystate Medical Center and University of Massachusetts Amherst researchers have published a new study that found a substantial reduction in recidivism when a jail offers those with opioid use disorder the option of medication-assisted recovery.
In an article published in the journal Drug and Alcohol Dependence, researchers found a 32% reduction in recidivism for those jailed by the Franklin County Sheriff’s Office between Jan. 1, 2015, and April 30, 2019, compared to the Hampshire County Jail and House of Correction. During that time period, Franklin County began offering inmates buprenorphine — a drug known by the brand name Suboxone that helps control opioid cravings — while Hampshire County didn’t begin giving the medicine until May 2019.
“When jails offer buprenorphine and other evidence-based medications to treat opioid use disorder, it can improve public safety,” said the study’s lead author Elizabeth Evans, a UMass Amherst School of Public Health and Health Sciences professor. “This is a critical outcome to be aware of as jails nationwide consider whether to offer this type of health care.”
Jail officials nationwide have often been resistant to such opioid addiction medications. However, in addition to reducing the number of former inmates who commit probation violations, get charged with crimes or get reincarcerated, researchers said the treatments are also likely to stem overdoses and drug use within U.S. jails.
Past research has also shown a decrease in drug use, overdoses and injection risk behaviors associated with HIV infection when inmates are provided methadone and buprenorphine.
“These results show convincingly that on top of their positive health effects, providing these medications to treat opioid use disorder in jail can break the repressive cycle of arrest, reconviction and reincarceration,” said Peter Friedmann, chief research officer at Baystate Health.
The researchers noted a “natural experiment” had taken place in Western Massachusetts, where the neighboring Franklin and Hampshire counties began offering buprenorphine at different times. They ultimately followed 469 adults who were incarcerated and had opioid use disorder — 197 in Franklin County and 272 in Hampshire County — and who exited one of the jails during the time period studied.
Using data from each jail’s electronic booking system, the researchers found that 48% of those jailed in Franklin County were arrested for further crimes after their release, compared with 63% in Hampshire County.
“In addition to the demonstrated reduction in overdose mortality, the current study provides legislators and correctional officials with compelling evidence that agonist medications in jail will reduce recidivism,” the study states. “Since recidivism and reincarceration are costly, and the implementation costs associated with agonist treatment in jails are substantial, future work should examine the state and societal costs associated with medications to treat opioid use disorder in jail.”
The study was funded by the National Institute of Health’s National Institute on Drug Abuse.
In 2018, Massachusetts lawmakers mandated expanded access to opioid agonist treatments like buprenorphine. The researchers noted that Franklin County was one of the country’s first rural jails to offer buprenorphine and naltrexone, which Sheriff Christopher Donelan said has resulted in reduced recidivism.
“It demonstrates that there is a positive reason to use medically-assisted treatment in a correctional facility,” he said, adding that this treatment was made available through federal grant funding. A second grant — the result of a collaboration between Hampshire County Sheriff Patrick Cahillane — has allowed for the expansion of the Hampshire County jail’s assistance program, meaning both facilities are now fully invested in this treatment.
Donelan said the program consists of two levels of success. The first manifests in improved behavior inside the facility after addicted inmates receive this medication for the first time, and the second comes in the form of reduced recidivism of released inmates, because they are less likely to possess narcotics or commit crimes to obtain money to purchase drugs.
“It’s working and I think, obviously, the study shows that,” Donelan said.
Dusty Christensen can be reached at dchristensen@gazettenet.com. Reporter Domenic Poli contributed to this article.