Inside California’s Program to Better Treat Addiction in Prisons

The statistics on drug addiction in American prisons are stark.

A majority of incarcerated Americans are estimated to have a substance-use disorder. And from 2001 to 2019, deaths in state prisons from drug or alcohol intoxication rose an enormous amount — by more than 600 percent.

Despite these heightened risks and the country’s ongoing opioid crisis, there historically has been little addiction treatment in correctional facilities. California is now trying to change that.

My colleague Noah Weiland, a health reporter for The Times, just published an article about a sprawling effort in California to treat addiction in prisons and jails. The state is one of only a few in the nation with a comprehensive treatment program across its prison system, something addiction and public health experts say is increasingly necessary.

“When someone leaves jail or prison not having been treated, their tolerance for powerful opioids can be diminished and their cravings can still be intense,” Noah told me. “A bad batch or a dose that’s too strong can be quickly fatal.”

California is on the vanguard of these efforts in part because the situation in the state’s prisons has become so dire. In 2019, California prisons recorded the highest overdose mortality rate for a state prison system nationwide, Noah reported.

The same year, Gov. Gavin Newsom and state lawmakers approved an extensive plan across the state for opioid addiction treatment in prisons, which can dull cravings and prevent withdrawal. It’s part of a larger strategy that breaks from the more common approach seen in many states that emphasizes abstinence.

“The record rate of overdoses in 2019 seemed to be the turning point,” Noah told me. “Few states have attempted such a far-reaching statewide medication program like this.”

Noah visited Valley State Prison in Chowchilla, northwest of Fresno, where inmates are screened for substance use when they enter the facility. That allows staff members to prescribe buprenorphine, which treats opioid addictions, early in a prisoner’s sentence. The hope is that their cravings will be stanched.

So far, California’s program seems to be working. It started in 2020, and in its first two years, overdose deaths among prison inmates dropped 58 percent, The Associated Press reported. Hospitalizations were about 50 percent lower among the roughly 22,000 inmates who received the anti-craving drugs compared with those waiting to begin treatment, The A.P. reported.

The state’s approach comes as the Biden administration aims to increase the number of prisons and jails offering opioid addiction treatment. The administration is also working to install treatment programs in all federal prisons by this summer.

California’s program is expensive: $283 million for the current fiscal year. But in January, it became the first state to secure permission from the federal government to use Medicaid for health care in correctional facilities, which will allow officials to use federal funds to cover opioid treatment.

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A plan to expand driverless taxi services in San Francisco has met stiff resistance from city officials and activists.

Where we’re traveling

Today’s tip comes from Cynthia Lee, who lives in Thousand Oaks. Cynthia recommends visiting El Pueblo de Los Angeles Historical Monument:

“Living in a suburb outside Los Angeles County, I’ve known tangentially about a cluster of historic buildings in downtown Los Angeles. But until I took a free hourlong walking tour with a well-informed guide from the volunteer docent group Las Angelitas del Pueblo, I had no idea how essential this site, El Pueblo de Los Angeles, was to understanding how this richly diverse city came to be.

It’s the city’s birthplace and one-time state capital. In this one spot on the map, the city’s oldest house, oldest church, first cemetery and original firehouse once stood. My guide gave me an overview of the city’s founding in 1781 and a sense of the tensions that arose as control over it shifted from the Indigenous Tongva to the Spanish, Mexicans and finally the Americans.

Being of Asian descent, I was especially moved by the sad history of Old Chinatown, also once there. The docent put real faces to so many local place names that I had long heard of: Pico, Sepulveda, Olvera, Stockton, Cabrillo, among others. And who knew that Los Angeles actually has a birthday — Sept. 4? I really recommend this experience to any visitor from near, like me, or far.”

Tell us about your favorite places to visit in California. Email your suggestions to [email protected]. We’ll be sharing more in upcoming editions of the newsletter.

Tell us

A number of Los Angeles landmarks are turning 100 this year, including the Hollywood sign, the Memorial Coliseum and the Biltmore Hotel in downtown.

Do you have any favorite memories of these institutions? Email a few sentences to [email protected], and please include your name and the city where you live.

And before you go, some good news

When Lauren Pariani and Kate Schatz first became mom friends after meeting on a school playground, they had no idea where life would lead them.