California prisons have life-saving addiction treatment. Doctors say the parole board is undermining it
CalMatters
California’s parole board is using unreliable drug test results in decisions about releasing incarcerated people despite flaws that were exposed in a rash of false positives two years ago, more than a dozen state prison doctors and state-appointed attorneys say.
As a result of the practice, which conflicts with policies governing prison health care, more and more incarcerated people are walking away from life-saving addiction treatment over fears that a false positive could cost them their freedom.
Records obtained by CalMatters show that 11 prison physicians last fall urged the parole board to stop using drug tests, which they wrote are prone to error, to determine whether to release someone. The practice, they said, erodes trust and has already begun dissuading their incarcerated patients from seeking help.
Fallout from addiction treatment comes at a critical time for the prison health system, which is trying to reverse a 39% increase in fatal overdoses among the people it served between 2019 and 2023.
The system uses an evidence-based intervention known as medication-assisted treatment, which combines counseling with medication that reduces cravings and prevents overdoses. Such interventions are “more important than ever,” a recent Correctional Health Care Services report stated.
Participating in the program requires frequent drug testing, which physicians use as a clinical tool to monitor treatment. The results “should be used only by healthcare providers,” wrote Correctional Health Care Services in an April 2025 memo. The presumptive tests can increase the likelihood of falsely testing positive for substances other than the prescribed medication.
“When someone refuses life-saving medication because they fear it will keep them in prison, the system has failed them.”
“When someone refuses life-saving medication because they fear it will keep them in prison, the system has failed them,” Robb Layne, executive director of California’s Association of Alcohol and Drug Program Executives, said in an interview. “Unless this is done correctly, medical treatment is being weaponized against people who need it the most.”
It’s not the first time the parole board has come under fire for keeping people in prison based on treatment records. Between April and July 2024, a lab error resulted in thousands of suspected false positive drug tests in California prisons. Nearly 100 people who tested positive for opiates during that time were denied parole, according to the corrections department.
Last year, the board recommended parole for about 24% of the incarcerated people who had hearings, according to state records. Denials typically cite multiple factors in the decision, but state-appointed parole board attorneys like Christine Morse suspect drug test failures can be decisive.
“It will sound like there are five or six different reasons,” Morse told CalMatters, “but sometimes, if you really read what the (parole board) commissioners are saying, it would all be different if that false positive weren’t there.”
In a statement to CalMatters, California Department of Corrections and Rehabilitation spokesperson Terri Hardy said the parole board “wants incarcerated people to seek treatment for their substance-use issues and strongly encourages them to rehabilitate so they can safely reenter the community.”
“For many parole candidates who come before the board for a suitability hearing, substance use is a risk factor that contributed to their commitment offense and is one of the most frequent parole violations,” the statement continued. “Because substance use can lead to future criminal conduct, the board considers all relevant and reliable information available to them, as required by our regulations.”
Drug testing in addiction treatment
In 2020, California prisons began providing addiction treatment as fatal overdoses soared nationwide. Roughly 50,000 incarcerated people have received medication-assisted treatment since then. As part of the program, Correctional Health Care Services requires presumptive drug testing at least every 90 days.
Those tests, which include disclaimers regarding the possibility of false positives, are meant to encourage an open dialogue with patients to help them in their recovery and should not be used punitively, according to Correctional Health Care Services’ policy and training materials for the parole board obtained by CalMatters. That policy reflects standards set by the American Society of Addiction Medicine.
In a September letter to the parole board, prison physicians noted that “urine toxicology, like many medical tests, is imperfect.” It’s why they should be understood in a clinical context, they wrote.
“We have personally had some of our most successful, stable patients test positive for substances they did not take due to false positives and cross-reactivity (prescribed medications interacting with the drug test),” the letter continued.
The parole board’s practice has resulted in a growing distrust of the treatment program, the physicians wrote. They noted that several of their patients no longer want to participate in the program “because the use of these tests by the parole board can be the reason between continued incarceration or freedom – even though these tests are not reliable indicators of a patient’s recovery.”