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New York Prison Lauded for Opiate Addiction Treatment Program

Posted on July 13, 2009 in Addiction Therapies

A human rights group has commended upstate New York’s Tompkins jail for its effective treatment of inmates who are addicted to opiates. Human Rights Watch highlighted the jail’s buprenorphine program as an example of the sort of medication-assisted drug addiction treatment that all jails in the state should be providing.

Buprenorphine is a medication that virtually stops withdrawal symptoms from opiate drugs such as heroin, methadone, Vicodin, OxyContin, codeine, and morphine. Many people find it extremely difficult to recover from opiate addiction because the withdrawal symptoms are so severe, so buprenorphine ameliorates the process.

At Tompkins, opiate-dependent prisoners are started on buprenorphine about one month prior to their release date, given a 30-day supply as they leave, and then linked to a licensed provider for continuing care. New inmates can also be given the drug to help with detoxification when they first arrive. The facility’s mental health director, Dr. John Bezirganian, started the program a few years ago.

Tompkins County is the only jail outside of New York City to offer such medication-assisted therapy, and the only one in the state to use buprenorphine. Rikers Island in New York City offers short-term detoxification treatments with methadone, a drug used to help wean heroin addicts off the drug. However, methadone is controversial due to its addictive nature.

Buprenorphine, however, is not addictive. No matter how much one takes, he or she will only get 20-30 percent of the effect of a full dose of heroin or morphine. In addition, if a person taking buprenorphine tries to take heroin or another opiate, he or she won’t be able to get high. Unlike methadone, buprenorphine has no street value and can be prescribed by a primary care physician. (People using morphine must go to a licensed dispensary every day to get their dosage.)

Dr. Bezirganian said he manages many of the buprenorphine cases himself, both in jail and in the community, and that it seems to be effective. Though not all inmates prescribed the treatment continue with it upon their release, many of them do, and Bezirganian said he believes it have saved more than one life.

“It’s a highly risky time when people leave a jail. If they return to their environment, there is a high risk of accidental overdose, and relapse in general,” Bezirganian said. “This way, at least they have a shot at choosing recovery.”

In November 2006, the New York State Commission on Correction notified county sheriffs and jail administrators of new federal regulations permitting easier administration of buprenorphine, and said that safe and effective opioid withdrawal treatment in jail is part of the generally recognized standard of adequate medical care. However, Tompkins is the only jail that provides this therapy.

The Human Rights Watch report said that the other 56 New York counties could correct this problem immediately, adding that punishment for drug use in New York State prisons is severe and out of proportion to the seriousness of the offense.

Prisoners who may be drug dependent are punished for symptoms of a chronic, relapsing disease,” it said. “Drug dependence treatment is withheld from prisoners who may need it as part of the disciplinary sanction.”

Provided by Elements Behavioral Health
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