Suboxone normalization (MAT normalization) is the reduction of diversion controls at the prison medline.
Prison systems can choose to monitor inmates who receive MAT narcotics, such as
Connecticut (CTDOC)
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and Rhode Island (RIDOC)
 Youtube: https://youtu.be/wpLhmtzjBvc?t=79 Vimeo: https://vimeo.com/300079114 |
In prison, MAT monitoring is a time- and labor-intensive procedure to inhibit the conversion of medications into contraband.
MAT normalization and Suboxone normalization are the same procedure to eliminate the above diversion controls.
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In 2019, Medication-Assisted Treatment (MAT) started at Colorado Department of Corrections (CDOC) with about a dozen participants.
The 2019 CDOC MAT policy required diversion controls including monitoring after Suboxone administration (policy is confidential). As MAT program participation increased, the diversion control requirements became very time-consuming for staff.
Between 2019 and 2022, suboxone administration at CDOC was characterized by inmates waiting 1-15 minutes after dosing.
MAT monitoring during this time was characterized by custodial staff and clinical staff observing inmates sitting on their hands or standing still while waiting for sublingual suboxone to dissolve. The goal of staff during this wait period is to prevent diversion of suboxone, a DEA schedule III narcotic.
This wait period was a “structural/operational barrier”
Sterling Correctional Facility (SCF) was the first CDOC facility to enact the Suboxone Normalization Pilots in 2022.
In an effort to solve the problem created by the time-consuming diversion controls, SCF was the first CDOC facility to pilot Suboxone Normalization.
https://www.youtube.com/watch?v=uy9nI7G0TzQ
The SCF Suboxone Normalization Pilot started in early 2022. A few months after the SCF Suboxone Normalization Pilot started, other Suboxone Normalization Pilots were started at other CDOC facilities. Diversion controls like the monitoring required by the 2019 CDOC MAT policy were ignored because of the Suboxone Normalization Pilots.
Between 2022 and 2024, CDOC conducted Suboxone Normalization Pilots which eliminated the 1-15 minute wait.
In October 2023, 804 inmates were enrolled in MAT at CDOC.
The Colorado Behavioral Health Administration (BHA) issued a Controlled Substance License (CSL) to Sterling Correctional Facility (SCF) from August 2023 through February 2024.
CSL requires adherence to certain standards as outlined in law…
SCF had been violating its MAT policy for about 20 months before BHA issued its CSL. After this provisional license expired, no other CSL’s were issued to DOC — except DRDC via OTP due to methadone requirements. In all facilities except DRDC, the department administers buprenorphine MAT under pharmacy license and individual practitioner licenses, not CSL nor OTP. SCF continued to violate its MAT policy for a total of about 31 months. Suboxone normalization started in early 2022 and ended when the new MAT policy promulgated August 2024.
An August 21, 2024 Colorado Department of Public Health and Environment (CDPHE) inspection found Buena Vista Correctional Complex (BVCC) deficient.
The 2024 CDOC MAT policy was promulgated August 22, 2024.
A July 28, 2025 CDPHE inspection found SCF deficient due to “the facility failed to ensure pharmaceutical services were provided in such a way as to ensure medications were not diverted” and “RNs did not inspect the patients’ mouths to ensure patients swallowed the medication..
Suboxone normalization refers to treating the sublingual placement of suboxone as the complete medication administration procedure.
Prior to normalization, the 1-15 minutes of monitoring was performed by custody and clinical staff. The current MAT administration practice in Colorado DOC is normalized due to the absence of MAT monitoring tested by the Suboxone Normalization Pilots.
| Why do inmates divert their pills? https://www.cdcr.ca.gov/bph/wp-content/uploads/sites/161/2023/12/ISUDT-BPH-Open-Session-December-18-2023-PowerPoint-Slides-1.pdf Slide 47 |  |
| 21 U.S. Code ยง 856 – Maintaining drug-involved premises Link to: https://www.law.cornell.edu/uscode/text/21/856 |
Why should prisons prevent medication diversion?
Inmates, visitors, staff and anyone who gets caught introducing drugs to incarcerated prisoners faces severe state retribution. Wardens should not encourage and supply a contraband market – but what are the consequences of that happening? What could be said of a prison that juices sub rosa narcotic trade?
Do prisons stimatize the vulnerable with security operations?
Typically, staff are not permitted to support black market inside detention facilities. This website aims to make plain the doublespeak of the Colorado DOC leadership and the actions the Department took to increase contraband within its facilities. Context about normalization and dynamic security is provided to promote discussion about MAT normalization.
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“I’ll be the first to tell you, you may not agree with every decision that I make because I don’t agree with every decision that my boss makes” -Executive Director Stancil, December 2022