In 2017, more than 1,000 people died because of drug overdoses in Connecticut, a 13 percent increase from 2016, according to Connecticut’s News 8. That amounts to nearly three deaths per day.
“For a state the size of Connecticut, that’s just crazy,” said Sam Marullo LAW ’20, the former policy director for Rhode Island Governor Gina M. Raimondo LAW ’98. “And if you dig into those numbers a little bit, more than half of those deaths were among former prisoners.”
In response, Marullo and Patrick Hulin LAW ’20, students in the Law School’s Legislative Advocacy Clinic, are championing a state bill that seeks to give prisoners struggling with opioid-abuse disorders access to medication-assisted treatment to help them overcome their addictions. In a 27–0 vote with no abstentions, the Public Health Committee of the Connecticut General Assembly referred the bill to the entire assembly on March 23. Now, the assembly has until the end of the legislative session next month to approve the bill, Marullo said.
Medication-assisted treatment is widely considered to be one of the most effective ways to combat drug abuse. According Marullo, a 2017 study in the United Kingdom found that inmates who receive medication-assisted treatment while serving their sentences are 85 percent less likely to overdose after they are released from prison. The Centers for Disease Control and Prevention corroborates the treatment’s effectiveness, saying it reduces opioid-abuse, opioid-related overdose deaths and criminal activity when used.
One of the bill’s biggest proponents, Hulin said, is state Sen. Terry Gerratana, D-New Britain, who announced her support in March.
“We have a moral duty to do better,” she said. “This is a public health crisis. . . . The [Connecticut Department of Correction] does not have the resources to offer evidence-based, medication-assisted treatment to most individuals.”
The few individuals who do have access to such treatment are part of a pilot program launched in 2013. The vast majority of prisoners, however, do not have access to this treatment, Marullo explained.
New Haven Mayor Toni Harp is one of six Connecticut mayors, including the mayor of Hartford, who wrote a joint letter to the legislature supporting the bill, claiming that the pilot program has delivered “impressive results.” They wrote the letter as part of a daylong public hearing testimony on March 16 and added that the state is not taking advantage of the opportunity to get people into treatment while they are imprisoned.
Others present at the hearing included state representatives, the state commissioner of public health and physicians associated with the Yale School of Medicine. Marollo added that no one at the event spoke in opposition to the bill.
In 2016, Rhode Island passed similar legislation, and the Massachusetts state legislature is also considering a bill that would give prisoners medication-assisted treatment for opioid-abuse disorders. Citing data released by Rhode Island Secretary of Health and Human Services Eric J. Beane, Marullo said the proposed bill could save more than 100 lives a year in Connecticut if it produces similar results to the ones in Rhode Island.
Marullo and Hulin added that it is important to realize not only that inmates are denied access to medication-assisted treatment but also that most receiving such treatment are taken off of it in prison, often before their case is tried. When this happens, these prisoners often suffer withdrawal symptoms.
Under the proposed legislation, prisoners would have the right to determine what treatment they receive.
While outspoken opposition to the bill has been limited, Marullo expects some opposition to the bill from those who worry about its cost and its impact on the state’s already overextended budget.
But Hulin said that, working with William Maher MPH ’19 and other students in the Yale School of Public Health, he has looked at fiscal models for the proposed policy and expects that it would save the state money in the long run by reducing drug abuse.
Still, “It would take a little while for the savings to show up,” he acknowledged, citing the added pressures of the state’s current “fiscal crisis.”
Nonetheless, he said he suspects the bill might be “caught up” in budget negotiations. The projected cost per prisoner is around $5,000 per year.
Hulin and Marullo are receiving course credit for their work on the bill, “An Act Concerning Access to Treatment for Opioid Use Disorder in Correctional Facilities.”
Niki Anderson | niki.anderson@yale.edu