Rhode Island's Master Plan: A Small State with Big Ideas in Addiction Recovery
How Rhode Island is Leading the Nation in Prison-Based Opioid Addiction Treatment
CRANSTON, R.I. — Paul Roussell, a 58-year-old former lobster fisherman, spent nearly a decade battling heroin addiction. What began as sniffing two bags a day escalated to seventeen. He supported his habit by running drugs for dealers and had accepted that his life might end in addiction.
But in a surprising turn, Roussell became the first inmate in Rhode Island to receive medication-assisted treatment (MAT) during incarceration. Instead of cold turkey withdrawal, he was offered methadone—a medication used for over 50 years to treat opioid dependence. “I started feeling like my recovery was kicking in,” Roussell says.
Inside Rhode Island’s Innovative Prison MAT Program
In 2016, Rhode Island became the first U.S. state to offer all FDA-approved MAT options—methadone, Suboxone, and Vivitrol—within its correctional facilities. The program was born from necessity: Rhode Island had the ninth-highest opioid overdose rate in the country. Each month, about 350 incarcerated individuals receive MAT, continuing their care through Medicaid upon release.
This continuity of care has had life-saving results. In the first half of 2016, 26 former inmates died of overdoses. After implementing the MAT program, that number fell to 9 deaths during the same period in 2017—a 61% reduction.
Real Stories of Recovery
After serving three months in prison, Roussell entered an eight-month inpatient program. Today, he’s heroin-free for over a year, works as a maintenance man, and visits a methadone clinic daily to stay on track. “That keeps me stable,” he says.
Another success story is Bill Fox, a 53-year-old released after a 26-year sentence. Three months before his release, Fox began taking Suboxone, which he now receives at a state-funded facility. “It keeps me off any hard drugs,” he says. “It regulates my life in a roundabout way.”
Michael Manfredi, who began using heroin at 15 and spent years in and out of prison, opted for Vivitrol before his 2016 release. Today, he attends peer recovery meetings, sees counselors, and has rebuilt his relationship with his daughter. “Vivitrol changed my life,” he says. “I didn’t think I could be a normal person.”
Why MAT Works—and Why It’s Controversial
MAT is widely recognized by public health experts as the gold standard for treating opioid addiction. But its use in prisons has long faced stigma. Critics often argue that methadone and Suboxone “substitute one drug for another.” Former U.S. Health Secretary Tom Price initially echoed this view but later endorsed certain MAT programs. Even today, many correctional systems ban opioid-based medications like methadone and Suboxone due to concerns over diversion.
Rhode Island’s program addresses these risks. Methadone is dispensed in liquid form with safeguards to prevent inmates from saving or sharing doses. Suboxone is provided in dissolvable strips to reduce contraband. And unlike most states, Rhode Island allows inmates to choose their MAT option—about 60% choose methadone, 39% choose Suboxone, and fewer than 1% choose Vivitrol.
A Model for the Nation
The success of Rhode Island’s program is drawing national attention. States like Massachusetts, Connecticut, Vermont, and West Virginia have begun expanding their own MAT initiatives in correctional facilities. Yet, most still fall short of offering the full range of medications or fail to continue treatment after release.
Governor Gina Raimondo, who spearheaded the Rhode Island initiative, believes MAT should be federally funded and adopted nationwide. “For a small investment, we could save tens of thousands of lives,” she said.
The Role of Continuity and Community in Recovery
Experts stress that MAT inside prison is only the beginning. Continued treatment, peer support, and housing stability are essential. “You shouldn’t even think about doing a program like this in a correctional setting if you don’t connect with [inmates] after release,” says Dr. Josiah Rich of Brown University.
In Rhode Island, these supports exist. CODAC Behavioral Healthcare, the state’s MAT provider, helps ensure that newly released inmates have access to continued medication and recovery resources.
MAT and Sober Living in Rhode Island
Recovery doesn’t end at release. Housing is a critical component of long-term recovery. Rhode Island offers a growing network of certified sober living homes, including those run by Vanderburgh Sober Living, which supports both men and women in Warwick, Pawtucket, and beyond.
If you or someone you know is in recovery and looking for sober living options in Rhode Island, visit our Sober House Directory to learn more.
Conclusion: A Path Forward for Prison Reform and Recovery
Rhode Island’s groundbreaking approach to treating opioid addiction behind bars proves that compassion, science, and smart policy can change lives. As overdose deaths continue to plague communities across America, states have a clear model to follow.
To explore more stories of recovery or learn how to open your own sober living home, visit VSL–the nation’s first organization offering sober living charters.