Suboxone normalization (MAT normalization) is the reduction of diversion controls at the prison medline.
Diversion controls are security controls to prevent contraband diversion. Inmates who divert, cheek, hoard, or sell their medication violate prison rules. Prison rules support the orderly operations of a correctional institution. Colorado DOC prison rules are written as policies and standards which are signed by department administrators.
Suboxone is a sublingual MAT medication that takes between one and fifteen minutes to dissolve under the tongue or held in the cheek. Suboxone normalization is the removal of the monitoring requirement after MAT medication administration. To prevent MAT narcotic diversion inside corrections facilities, diversion controls attend medication administration. MAT monitoring is staff observing inmates waiting for sublingual MAT medication to dissolve.
Even in the context of the institutional practice of monitored medication intake, MAT monitoring goes beyond the typical practice of cheeking prevention.
The 1-15 minutes of MAT monitoring is an additional queue with additional security requirements managed by an additional staff member. When the MAT medication is administered cellside, the MAT monitoring is performed cellside to prevent the MAT medication from being diverted.
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 such as monitoring after Suboxone administration. As MAT program participation increased, the diversion control requirements became very time-consuming for staff.
In October 2023, 804 inmates were enrolled in MAT at CDOC.
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.
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.
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. Current MAT administration in CDOC is normalized due to the absence of MAT monitoring: inmate patients receive the sublingual MAT medication then walk away.
The current MAT administration practice in Colorado DOC was tested by the Suboxone Normalization Pilots.
Why?
Left to their own devices, incarcerated inmates divert buprenorphine
Knowingly enabling sub rosa trade of contraband narcotics in a prison system should satisfy a criminal conviction. This website aims to make plain the doublespeak of the Colorado DOC leadership, the actions the Department took to worsen contraband availability within its facilities, and the harmful effects which have resulted. This is a work in progress, and this website is under construction.
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