Many people can’t get access to opioid medication treatment while incarcerated, or have trouble accessing treatment once released. A community clinic in Alaska is trying to help.
SCOTT SIMON, HOST:
Inmates and people recently released from jails and prisons are among the most vulnerable to dying from a drug overdose. Experts say many don’t get the treatment they need. In Southcentral Alaska, one group is trying to change that, as Rachel Cassandra of Alaska Public Media reports.
SARAH SPENCER: How have you been feeling as I saw you last?
H: Pretty good.
RACHEL CASSANDRA, BYLINE: At the Ninilchik Community Clinic on Alaska’s rural Kenai Peninsula this summer, Dr. Sarah Spencer preps a patient who’s getting a monthly buprenorphine shot to treat her opioid use disorder.
SPENCER: I’m going to go on a different spot because that’s really close to your last shot, and I can feel it there.
CASSANDRA: This clinic is run by the Ninilchik Village Tribe. They serve tribal members and nontribal patients. Spencer’s patient is a woman who asks that we use only her first initial,H. She says she has a warrant out for her arrest and is expecting to go to jail for about six months. We met with H in August, and NPR agreed to identify her only by her first initial because she spoke critically of the Alaska Department of Corrections, and she’s afraid of retaliation from staff in jail.
SPENCER: OK.I’m going to give you a little pinch.
CASSANDRA: H says there are sometimes contraband drugs in jail, and she wants to get these shots so she has the best chance of staying sober while incarcerated.
H: I wanted to cover my bases because I really, really wanted to do good.I didn’t want to go backwards.
CASSANDRA: Many studies have shown that medication for opioid use disorder makes recovery more likely and reduces the risk of overdose death. If people aren’t able to get medication while incarcerated, they may relapse in prison on black market drugs. Or if they don’t use opioids inside, they will detox and their tolerance will go down. That makes them more susceptible to overdose when they leave.
SPENCER: There is no population that’s at higher risk than people who have been recently incarcerated. And a big part of that is as it only takes two weeks for people to lose their tolerance to opioids.
CASSANDRA: Research backs up the idea that people sent to jails and prisons are incredibly vulnerable to drug death. Federal data released by the Biden administration showed up to 1 in 4 overdose deaths nationally in 2021 involve people recently released from jail or prison. H says the treatment for her opioid addiction was interrupted when she was incarcerated earlier this year. She says the Alaska Department of Corrections denied her medication and that she started using illicit opioids again when she got out.H: It happens superfast. You run into people. You see people. It’s just – there’s a thousand different ways.
CASSANDRA: Interviews with health care providers like Dr. Spencer and formerly incarcerated people like H indicate that many who want medication while incarcerated don’t get it. Alaska’s Department of Corrections, or DOC, declined repeated requests for an interview for this story, but they responded to questions over email. They confirmed that they only give short-term medication treatment to people who were already getting it before they went to jail or prison and saeid that no one gets treatment past 30 days unless they’re pregnant. When they’re released, DOC says they give some people a list of providers they can go to for treatment. But Spencer says best practice is to make it much easier for every inmate to start on medication.