The state is working with the Penobscot County Sheriff’s Office to develop a blueprint for establishing medication-assisted opioid treatment programs inside Maine county jails.
Officials said they are collaborating on a set of guidelines that they plan to share in the fall with sheriffs, who independently oversee the state’s local lockups.
The move signals the first unified effort to push for the wider availability of such medications inside Maine’s local correctional facilities, where they are mostly banned or severely limited despite high rates of opioid addiction among the state’s incarcerated population.
Implementing these programs could still be a long way off, officials said. It will be up to individual sheriffs to find the funding, adopt the protocols and ultimately decide whether to offer the programs.
But courts continue to side with inmates who have sued to force Maine jails to give them their addiction medications, and looming court orders have put more pressure on lockups to start planning.
Penobscot County Sheriff Troy Morton, who is also vice president of the Maine Sheriffs Association and approached the state about crafting the guidelines, said he hopes this effort with jumpstart the process. It also lines up with the policy goals of Democratic Gov. Janet Mills. Under new leadership, the Maine Department of Corrections launched a MAT pilot program inside the state prisons on July 1.
Right now, only three of Maine’s 15 county jails allow a limited number of inmates to take medications such as buprenorphine, methadone and naltrexone, which mitigate withdrawal symptoms and/or reduce cravings from opioid addiction and are considered the medical standard for treating the disease. (A fourth, Two Bridges Regional Jail in Wiscasset, is expected to start in August.)
As a result, the treatment a Maine prisoner receives behind bars, if any at all, depends where he or she gets arrested. Some sheriffs have cited fears that some of those medications will be diverted and abused, among other logistical challenges, as a reason not to provide them.
Morton started Maine’s first jail-based medication-assisted program in 2017. He approached the state agencies in June to pitch the idea of working together to craft statewide guidelines.
He is primarily working with Ryan Thornall, deputy commissioner for the Department of Corrections, and Dr. Lisa Letourneau, an advising clinician with the Department of Health and Human Services. Their long-term goal is to make these medications available to those behind bars who need them, they said.
“MAT is going to become the new norm as these things roll forward,” Thornall said.
The protocols are still being drafted but will draw on the recently rolled out medication-assisted treatment pilot in Maine prisons and similar programs that have existed in jails, such as Morton’s at the Penobscot County Jail. Officials stressed that they would be customized to the facility, but emphasize certain best practices regarding eligibility, maintaining people in the program and ensuring that participants are handed off to a treatment provider in the community following their release.
As of July, Kennebec and York counties also had pilot programs that offered the medication Suboxone to a pilot group of inmates.
Creating a standard set of guidelines is not only meant to encourage more of these programs, but also ensure a smoother continuity of care between Maine’s jails and prisons, officials said.
“Our [number one] interest is … having as much [medication-assisted treatment] services available in the correctional system in Maine,” Thornell said.
Letourneau said she is meeting with staff from the Office of Substance Abuse and Mental Health Services and providers to work on the policy. The group expects to have recommendations to share with sheriffs at a meeting in September.