State prisons are required under the U.S. Constitution to provide “adequate medical care” to those they incarcerate. However, prisons in New Mexico and 16 other states do not directly provide inmates with medication for opioid addiction, and neither do most of its county jails. Advocates are calling on lawmakers to expand this treatment in New Mexico lockups in the upcoming legislative session.
Medication-assisted treatment — or MAT — for opioid use disorder includes Food and Drug Administration-approved drugs like methadone, buprenorphine and naltrexone, along with counseling, case management and drug testing.
One of a handful of county jails in New Mexico that provides MAT is the state’s largest — the Metropolitan Detention Center in Bernalillo County.
Recovery Services of New Mexico administers the MDC program in collaboration with the jail and Bernalillo County’s Behavioral Health Services Department. Medical Director Dr. Sergio Huerta presented to the Legislative Health and Human Services CommitteeMonday and told lawmakers that providing the treatment in jails is uniquely beneficial.
“Providing MAT actually reduced the rate of fatal overdose when people were released by up to 60%,” he told the panel of state lawmakers.
Huerta said receiving MAT while incarcerated also leads more people to stay in treatment on the outside and lessens the likelihood they’ll get locked up again.
He called the sparse availability of the treatment in prisons and jails “a sad reality,” and said that while barriers like accreditation requirements, security, staffing and cost all play a role, stigma also limits access.
“There’s been an underlying associated stigma when it comes to MAT — thinking that it’s substituting one substance for another, when that’s really not the case,” he said.
That appears to be part of the rationale the New Mexico Corrections Department uses in withholding MAT from most inmates.
Spokesperson Carmelina Hart told KUNM in an email that “the overall goal for those in our care is a place of sobriety.” She said most people are tapered off the medication before coming to state facilities and, in some cases, will be held in county jail until they have.
She added that some people in their custody do have access to MAT, but through community partners.
Pregnant people already on medication when they arrive — a small fraction of the prison population — continue care through the University of New Mexico’s Milagro program, according to Hart. She added that “in rare situations, NMCD will transport an inmate to a local hospital where a medical determination is made on the best form of treatment for that specific case.” She did not say whether, or how often, the decision is made to allow that incarcerated person to take medication for opioid use disorder.
State Sen. Antoinette Sedillo López, D-Bernalillo, expressed concern over the lack of medication-assisted treatment in New Mexico state prisons.
“I think if the state — if it doesn’t do that — risks a lawsuit.”
Huerta urged lawmakers to support state prisons and other county jails in overcoming barriers — real or “perceived” — as his program has at MDC.
He recommended the state allocate funding from the state’s cut of a $26 billion national opioid settlement toward the effort. Treatment for incarcerated populations is listed as a “core strategy” in the state’s allocation agreement.
The Your New Mexico Government project is a collaboration between KUNM and New Mexico PBS with support from the Thornburg Foundation.