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The a2A Mission:
Our mission is to uniformly expand access to MAT for opioid use disorder in correctional facilities.
Our goal is to save lives and end the opioid crisis.

The opioid crisis is a complex issue with many moving parts. What began as an epidemic involving prescription opioids evolved into a crisis spanning dozens of illegal and legal drugs. The advent of illicitly-manufactured fentanyl (IMF) has dramatically altered the trajectory of the crisis, and deaths linked to IMF have increased by 540% since 2016. If we don't act now, the death toll is projected to reach 500,000 by 2027.  

There are three main roadblocks that often stand in the way of opioid addicts receiving treatment with MAT:

(1) Lack of access to MAT in most correctional facilities;

(2) Lack of physicians and clinics that provide MAT services 

(3) Lack of understanding about addiction, and the consequent stigmatization of the disease.


Beating the opioid crisis requires removing each one of these roadblocks, and this requires work on all of our parts. It won't be easy, but it has to be done, and here are some ways we can do it:

The Criminal Justice System 
  • End the practice of forced abstinence

  • Incorporate OUD treatment, including MAT, into the criminal justice process 

  • Focus on recovery and rehabilitation as opposed to punitive measures

  • Stop prosecuting low-level drug crimes 

  • Accepting relapse as a normal part of the disease process as opposed to a probation or parole "violation"

  • Eliminate court-ordered forms of treatment and allow the individual and their healthcare provider determine the best approach

The Medical Community
  • Integrate MAT into primary care settings/ERs

  • Mandate buprenorphine waivers for all primary care physicians

  • Increased medical school and residency training in the treatment of addiction

  • Remove the stigma of addiction, substitution therapy with buprenorphine or methadone

  • Mobile treatment services in economically disadvantaged areas

  • Broaden access through specialized community pharmacies, mobile treatment services, and hub-and-spoke model of care


  • Lift restrictions on buprenorphine prescribing for primary care physicians 

  • Exit the U.S. drug war and make harm reduction the cornerstone of U.S. drug policy 

  • Shift the focus from failed-supply side programs to effective demand strategies

  • Reform the U.S. drug scheduling system

  • Negotiate with pharmaceutical companies to expand access to life-saving medications for preventing opioid overdoses

  • Limit the Drug Enforcement Administration's authority over the practice of medicine 


what all of us can do

Treat people with dignity & kindness
Listen without judgment
Replace prejudice with evidence and facts
Speak up when you see any kind of stigma
Recognize that addiction is a medical illness
Avoid using disparaging labels like "junkie"

There are many frustrating aspects of the opioid crisis, among them being that it continues to worsen despite the existence of safe and effective, yet woefully underutilized treatments. Addiction experts are unanimous in that early intervention with MAT is key to saving lives and reducing the opioid related death toll, and our current system is inimical to this mission; incarceration not only delays this crucial intervention and treatment, it renders addicts more susceptible to overdosing upon release. The bottom line is that we can no longer afford to ignore the opioid crisis, and if our system insists on criminalizing drug addiction, thereby taking this deadly public health crisis into its own hands, our correctional centers should at the very least shoulder the responsibility of actually treating and contributing to the rehabilitation of incarcerated addicts.

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