On April 13, the Colorado House Judiciary Committee approved a bill to re-impose felony penalties on fentanyl—and by extension, any unregulated drug that contains fentanyl. The bill is now on its way to the House Appropriations Committee, and it’s likely that Governor Jared Polis will sign it.
While the real-world implications of re-felonizing fentanyl have dominated the discussion, the bill also contains several provisions that affect access to medications for opioid use disorder (MOUD) for people incarcerated in the state’s prisons and jails. Or at least, have the potential to affect them.
House Bill 22-1326 would allocate $3 million for county jails receiving behavioral health funds to create policies describing how they’d provide MOUD to eligible prisoners as well as those being released. But it doesn’t actually require them to provide the medications; just create the policies. The bill has similar stipulations for halfway houses.
The period immediately following release from prison is extremely high risk for overdose, with some research finding that someone released from custody in the past two weeks is more than 40 times likelier to die of overdose than the general population. Access to MOUD while still inside carceral facilities is shown to overwhelmingly reduce this risk.
“Counties out there in the rural frontier areas, they just don’t have the capacity to hire a medical provider.”
These provisions all build on a 2019 bill that enabled state prisons to provide MOUD, and required certain county jails to create policies for doing so. Jails and prisons throughout the country will regularly deny people access to MOUD. Of the three FDA-approved medications, buprenorphine, methadone and naltrexone, the first two are shown to reduce risk of fatal overdose, and the third is what’s widely preferred by corrections departments.
“We were able to secure funding [in 2019] to jails to get them up to speed with providing [MOUD] in their facilities,” José Esquibel, director of the Colorado Consortium for Prescription Drug Abuse Prevention, told Filter. But that money was limited—the new bill would add an additional funding source to help county jails close some of the gaps.
The bill would also strengthen MOUD access in state prisons by providing funds for facilities to purchase the medications, as well naloxone and fentanyl test strips.
“In Colorado we have quite a few counties that are out there in the rural frontier areas, and they just don’t have the capacity to hire a medical provider to do this,” Esquibel said. “We’ve been working with frontier and rural counties to facilitate more access to [MOUD] and partnering with state folks who have a mobile van.”
On April 5, the Department of Justice released a guidance document clarifying that people with opioid use disorder have a legal right to MOUD under the Americans with Disabilities Act.
“If they’re not providing that service, they’re in violation of federal law,” Esquibel said. “And that needs to be motivation for folks to want to avoid litigation.”
Photograph via North Carolina Department of Health and Human Services