Copyright © 2021 Albuquerque Journal
After months of delays, the Metropolitan Detention Center launched a program to provide buprenorphine to those in jail who are already using it to treat their opioid addictions.
The buprenorphine maintenance program can provide an average of 22 inmates per day with the medication. Those who are eligible are identified through the jail’s intake screening process, according to a spokesman for Bernalillo County.
“Maintenance of buprenorphine medication-assisted treatment will ensure that individuals who are engaged in community-based recovery efforts can continue to receive supports while incarcerated at MDC and will subsequently support successful reentry upon release,” Evan Gonzales, a spokesman for the county’s Department of Behavioral Health Services, wrote in a news release.
Recovery Services of New Mexico – a treatment organization run by BayMark Health Services – received a contract to provide the medication at the jail late last year. The county signed a two-year contract agreeing to pay the organization just under $250,000 for services and $312,400 for the medication itself. Gonzales said that because the contract is set up as a “fee-for-service model” no invoices were processed before Wednesday, when the program began.
Recovery Services has been providing another medication-assisted treatment – methadone – in the jail for years. However, methadone and buprenorphine aren’t interchangeable for patients.
According to the contract, Recovery Services initially said it could begin providing buprenorphine in late 2020, but the start date was pushed back repeatedly.
A county spokesman told the Journal in May it was projecting that the program could begin in June, but even at that time a representative from BayMark seemed unsure. She blamed delays on challenges associated with the COVID-19 pandemic. Gonzales said more recently that delays came from the New Mexico Board of Pharmacy.
“The circumstances for delivery of buprenorphine to patients is very unique and a new approach for the (Board of Pharmacy) to conceptualize and provide approval,” said Patrice Trisvan, a senior vice president with BayMark Health Services. “The Board of Pharmacy required certain policies and procedures to be clarified in order to heighten their level of comfort for this project to be implemented. This process took longer than expected, but the end result is that all invaluable stakeholders have the belief that this will be a safe, effective program to treat patients with opioid use disorder who are incarcerated at MDC.”
For now, Recovery Services will provide buprenorphine only to those who had already been using the medication before they were locked up. However, Gonzales said, the county will explore expanding the program to start people on the treatment.
Dr. Bill Wiese, the former chair of the county’s Addiction Treatment Advisory Board, said he thinks the jails should have started providing buprenorphine years ago.
Furthermore, he said, a program that doesn’t start new patients on the treatment is akin to not starting a diabetic on insulin in the jail if they hadn’t already been taking the medication.
“It’s no different, from a medical point of view,” he said. “There is a difference from a public health point of view. This would have extraordinary public health benefits. … If they’re not induced, you’re missing an opportunity to get someone with a serious chronic disease with social consequence as well starting on medical therapy.”
He said that although medication-assisted treatment might not be successful for all patients, a substantial portion will be able to use it to turn their lives around.
“That it’s not happening is a medical travesty,” Wiese said.
Medication has been used to treat opioid addiction for decades. Methadone was approved by the Food and Drug Administration in 1972, and suboxone, which contains buprenorphine, was approved in 2002.
Ed Hunt, vice president for correctional services at BayMark Health Services, said the buprenorphine maintenance program is an extension and expansion of a partnership between the jail and Recovery Services dating back to 2009.
“This was one of the nation’s first public-private partnerships to offer opioid treatment of this magnitude within the confines of a correctional institution,” Hunt said.
New Mexico had the 12th-highest rate of drug overdose deaths in the country in 2019, according to Bernalillo County. Gonzales said prescription opioids and heroin have been among the most common drugs causing overdose deaths for the past several years.
“Medication-assisted treatment has proved to be clinically effective to significantly improve patient survival, increase retention in treatment, decrease illicit opiate use and other criminal activity among people with substance use disorders, and increase patients’ ability to gain and maintain employment,” Gonzales said.
Bernalillo County Manager Julie Morgas Baca said the county’s “trailblazing efforts” to introduce medication-assisted treatment into the jail has provided opportunities for the county to learn from its efforts and support others who want to start similar programs.
“Individuals incarcerated at MDC are primarily part of our most vulnerable populations and are experiencing a high need for substance use supports, and although incarcerated, we have an obligation to offer behavioral health supports to all community members,” Morgas Baca said. “This collaborative approach between our detention facility and community-based providers ensures that we are maximizing resources and effectively supporting the community.”