What is Medication Assisted Treatment (MAT)?
MAT is a form of substance abuse treatment that uses a combination of counseling, behavioral therapies, and the Food and Drug Administration (FDA) approved medications to treat Opiate Use Disorders (OUD). Three medications that have been approved by the FDA for use in MAT include methadone, buprenorphine, and naltrexone.
How does the Americans with Disabilities Act (ADA) or the Rehabilitation Act apply to state and federal prison inmate access to MAT?
Under the Americans with Disabilities Act (ADA), an OUD is considered a disability because it is a physical or mental impairment that substantially limits one or more major life activities. The ADA applies to the protection of a person in recovery from an OUD, as long as they are no longer engaging in the illegal use of drugs. The United States Supreme Court has held that the ADA applies to inmates of government-run prisons under Title II on both the state and federal level. Federal prisons, as part of federal executive agencies, are subject to the Rehabilitation Act of 1973, which, like the ADA, provides protections against discrimination on the basis of a disability.
What state or federal prisons in Region VIII currently offer MAT treatment for prison inmates?
Colorado offers Vivitrol (a form of naltrexone) for the treatment of OUDs and has recently passed legislation to require the continuation of MAT to inmates who had been receiving MAT at a local jail prior to their incarceration. Utah offers Vivitrol to prison inmates and has recently passed legislation to require the compilation of annual reports to investigate the potential use of MAT in prisons and jails. Montana is in the process of developing a prison MAT program, with a goal of implementation by the end of 2020. North Dakota offers a methadone program for certain inmates. Currently, there are no MAT programs in place in either South Dakota or Wyoming. Federal prisons offer limited methadone use for inmates.
Future Outlook for Prison Inmate Access to MAT
There have been several legal cases recently that forced the federal Bureau of Prisons to provide access to MAT for inmates. Currently, Rhode Island is the only state to offer all three MAT medications for prison inmates. New Jersey, Kentucky, and Massachusetts also offer limited MAT medications to their state prison inmates. The success of these state programs, combined with the legal cases, state and federal legislative initiatives, and a better understanding of MAT suggest that inmate access to MAT will expand in future years in both state and federal prison systems.