Pennsylvania prisons now give suboxone to thousands of inmates, with thousands more on the waiting list. It's costing taxpayers tens of millions of dollars and raising questions about its effectiveness.
Pennsylvania prisons expand suboxone use—but is it working?
In Pennsylvania, most inmates with a substance abuse history are now put on a drug called suboxone, like methadone in the past. It's meant to ease them off opioids like heroin and fentanyl.
In Pennsylvania and across the nation, suboxone is being heralded as the answer to addiction, especially in prisons and jails. Once on it, proponents say those with substance use disorder run little chance of overdose and are more likely to seek recovery when they leave prison, making them less likely to return.
"We have no stronger evidence in addiction treatment," said Allegheny County Human Services addiction specialist James Loveland. "Less risk of overdose, more likely to go to treatment, less likely to go to a hospital."
But critics say suboxone is no miracle cure and that inmates and others are merely trading one addiction for another at the public's expense.
"They've created a world full of dependent people on another substance," said Habitat for Recovery's Jim Antal, who runs a recovery house. "So, what have you really done? You haven't accomplished anything."
Like other prison systems across the nation, the Pennsylvania Department of Corrections is all in on suboxone. In the past two years, the number of inmates on the drug has spiked from 1,800 to more than 5,000 - an increase of 184 percent. All inmates in the system can now apply to be put on suboxone and there are 4,000 more on a waiting list to be screened, raising concerns at a recent hearing that corrections officials are pushing the drug.
"They're being put on suboxone, they're being basically encouraged to be put on suboxone," said Pennsylvania Sen. Cris Dush. "Is that part of what's driving this? That's a significant number of people."
"I just talked about 57 percent of our population has an substance use history and that's a significant number of individuals in our system," said Pennsylvania Department of Corrections Secretary Laurel Harry. "Our addictionologists meet with individuals, they talk to them, of course, especially for folks going back out into the community."
But the costs are staggering. An injection of buprenorphine lasts a month but costs $1,630. Oral medication is $55 a month. With their expanded use, the cost of the program has ballooned to $36.7 million a year. Those costs are only going up and don't include money being spent at county jails, including the Allegheny County Jail. Still, Loveland says it's worth the money.
"It sounds expensive until you realize the alternative is even more expensive," Loveland said.
Prison systems across the country believe more inmates will seek recovery programs after their release and there will be far less recidivism, or their returning to the cycle of crime and jail. But suboxone is still an opioid and addictive by itself. Those who have used it say it gets you high and it's difficult to quit. Some in the recovery community say being on it is not the same as being clean and sober.
Twelve years ago, Jim Antal opened a recovery house primarily for ex-inmates on the North Side, but after a host of problems, he no longer takes those who want to use suboxone, only inmates who are trying to be entirely free of drugs and alcohol. Antal believes states are enabling addiction by expanding the use of suboxone in prison.
"I don't think the government realizes what they're creating, a monster. They've never seen anything like this," Antal said.
And so this is one big experiment on the prison population. If successful, more inmates will pursue a path of recovery and become productive citizens, turning away from a life of crime. If not, the government is spending millions keeping people addicted, making a quarter of the prison population docile and high.
