In early 2019, Maine Governor Janet Mills signed an executive order directing state resources to be directed at the Maine Department of Corrections (MDOC) to help justice-involved residents suffering from opioid addiction. After getting the okay from the governor, Deputy Commissioner Ryan Thornell, who oversees the program, brought together staff from all levels in the MDOC to participate in a steering committee to map out the timeline and procedures for implementing MAT treatment for residents. This committee consisted of security staff, nurses, case managers, administrators, clinicians, and community treatment professionals. One of the important pieces was listening to concerns from security officers who worried medication assisted treatment (MAT) was similar to contraband items forbidden by the MDOC.
Maine’s pilot MAT services started at four of the state’s six adult correctional facilities focusing on caring for residents who fit medical criteria and were 90 days from their release date. This pilot was population focused on ensuring continuity of care so that as the client was released, he or she had a solid plan in place to continue treatment and engage with community programs like peer support, harm reduction, and community-based recovery groups. By November 2019, the department expanded MAT access to a fifth facility, and three months later, in February 2020 expanded MAT access to the remaining sixth facility, the Maine State Prison.
Less than a year after the pilot, MDOC expanded the MAT program again to provide different types of buprenorphine and naltrexone to residents six months from their release date and provide maintenance to those entering the system already on an MAT, including methadone. By May 2021, the eligibility criteria were further expanded to include residents who still had two years until being released. Today, MAT services are universally accessible to any resident in Maine’s state correctional system, regardless of sentence length. MDOC started with about 100 residents and now reaches about 700 adult residents a year.
Program Fees & Funders
Costs associated with the first-year pilot during fiscal year 2020 totaled $1.2 million and included $450,000 in braided funds through a partnership with the Maine Office of Behavioral Health (OBH) and the Director of Maine’s Opioid Response, Gordon Smith. With the expansion in 2021, costs increased as projected, but they were below expectations, totaling close to $930,000. Ongoing costs for the service will run close to $1.5 million, which is about $500,000 less than originally anticipated, the added costs related to universal expansion.
Program Performance & Metrics
As Maine evaluates the costs associated with this established service, the department will be able to continue using the braided funds from state and federal agencies, will tap into overall savings acquired through reduced costs from having more healthier residents, and consider the option of establishing an Opioid Treatment Program within a facility, which some addiction professionals say is the most cost-effective manner to way administer methadone to residents. In addition to treatment, MDOC staff has been focused on reducing the stigma of addiction recovery among residents. For example, staff worked to change their language in speech and in documentation to non-stigmatizing, person-first, person-centered language, using terms like “resident,” “client,” and “person with substance use disorder. MDOC has done away with stigmatizing words like “prisoners,” “probationers,” and “drug addicts.
For the future, the MDOC plans to continue universal access to MAT and look to meet other cross-over needs for residents, such as treatment for Hepatitis C.
Maine Department of Corrections Central Office
25 Tyson Drive, Third Floor
State House Station 111
Augusta, ME 04333
Randall Liberty, Commissioner
Ryan Thornell, Ph.D., Deputy Commissioner
Gary LaPlante, Director of Operations
Susan Gagnon, Director of Adult Community Corrections
Anna Black, Director of Government Affairs