PREVENTING RECIDIVISM BY PROVIDING A PILL

Volume 29, Issue 508 February 4, 2008

Matthew Gever

New Mexico may become the first state in the nation to try to reduce prison recidivism by providing released prisoners with an anti-addiction drug.

If passed by lawmakers during the current 2008 session, HB 244 would create an opiate addiction treatment program. The pilot project would enroll 50 female prisoners with a history of heroin or other opiate addictions for outpatient treatment utilizing buprenorphine.

Approved by the Food and Drug Administration in 2002, buprenorphine treats opiate addiction by preventing symptoms of withdrawal. The New Mexico experiment would use a form of buprenorphine that has been combined with the opiate antagonist naloxone. By blocking the pleasurable effects of buprenorphine, naloxone helps prevent relapse as well as diversion of the drug (sold under the trade name Suboxone) to the black market.

Addiction experts say there are few available means of preventing relapses: they include AA or Narcotics Anonymous, and methadone. Advocates say buprenorphine is an improvement over methadone because it can be prescribed in an office setting by any certified physician, which allows patients to take a supply home and avoid making daily trips to a methadone clinic.

Approximately 600 women reside in the New Mexico Women’s Correctional Facility in the city of Grants and another 70 reside at the Camino Nuevo Correctional Center in Albuquerque. Of these women, 85 percent have a history of addiction and 40 percent have a history of injection drug use.

The recidivism rate among this population is high. “Seventy-five percent of women who go to prison for the first time for narcotic-related crimes will re-offend and return to prison within 2.5 years,” says an analysis from the Legislative Finance Committee. These female recidivists cost the state $3 million per year, according to the Department of Health (DOH).

Currently, Medicaid does not cover outpatient substance abuse treatment in New Mexico. The state often ranks near the top of the list of states in the numbers of people who need treatment but do not receive it. The Drug Policy Alliance of New Mexico attributes much of the problem to lack of insurance coverage.

To qualify for the new program, inmates would have to be within two months of release and not pregnant. Participants also would be on parole or probation for at least one year following release, and they must meet with a case manager regularly during the course of the project. Those released to a community within 60 miles of a physician certified to prescribe buprenorphine would receive priority.

The state would appropriate $250,000 from its general fund to cover the full costs of the two-year project. DOH and the Department of Corrections would be responsible for evaluating the project, measuring decreases in recidivism, relapse and cost savings. Additionally, state officials will look for changes in the physical and mental health, employment status and other quality of life indicators among participants, comparing these indicators to women with a history of opiate addiction who were not treated with buprenorphine.

Some believe that the program will help not only the former inmates, but their families. “Most women in prison are mothers,” said Angie Vachio, executive director emeritus of PB&J Family Services, a child welfare organization that serves children whose parents are in prison. According to DOH, the 600 incarcerated women in New Mexico leave behind 1,800 children. “When children watch their mothers do well and see effective treatment, that’s the best possible investment we can make in families,” added Vachio.

HB 224 has cleared the House Judiciary Committee and will now move to the House Appropriations and Finance Committee. The Legislature passed a similar bill during the 2007 session, but it was vetoed by Governor Bill Richardson, who said there was not enough money in the budget at the time.

© Copyright 2008, State Health Notes