Forum explores medication-assisted opioid treatment for inmates

  • Hamsphire County Sheriff Patrick J. Cahillane speaks about medication-assisted treatment for opioid use disorder at a forum at the University of Massachusetts Amherst on Friday.  PHOTO COURTESY OF TOM MITCHELL

For the Gazette
Published: 9/16/2019 12:03:57 AM

AMHERST — Adam “didn’t grow up wanting to be a heroin addict,” he told a room full of community leaders Friday morning.

Although a “series of bad decisions” led him to an addiction and substantial criminal record, he’s a different person today than he was six months ago, he said. He has moved into a sober living house, attends daily 12-step meetings, and when he starts thinking about using, he knows any drug he uses won’t work as intended, and he loses the urge — thanks in part to the medication Vivitrol, a regimen he began as an inmate at the Hampshire County Jail and House of Corrections.

Adam was one of the panel speakers at a forum Friday morning hosted by the Hampshire County Sheriff’s Office at the University of Massachusetts Campus Center and attended by local first responders, treatment providers and others on the front lines fighting substance abuse.

Hampshire and four other county jails — Franklin, Hampden, Middlesex and Norfolk — have received grants under the CARE Act, which passed in January, as part of a statewide medication-assisted treatment (MAT) pilot program. That number has since grown to include seven facilities statewide, Hampshire County Sheriff Patrick Cahillane said.

Approximately 88 percent of the jail’s inmates struggle with substance abuse, and around half of them struggle with opioids, Cahillane said. Medications such as Vivitrol work by attaching to opioid receptors in the brain, according to Vivitrol’s website, and blocking the “high” produced by opioids, thereby discouraging use.

“The MAT program is intended to reduce deaths,” Cahillane said.

The pilot program expanded on the sheriff’s office’s existing medication-assisted treatment program, which was started at the jail in 2013 with naltrexone (Vivitrol), according to a sheriff’s office handout. In 2017, the jail added another medication option, buprenorphine (Suboxone).

Under the pilot program, the jail is now offering methadone as well, Cahillane said.

The medication-assisted treatment program consists of maintenance, or ongoing medication for inmates who were already on one of those medications before incarceration, and “induction,” which is offered to inmates who are being released within 60 days.

Induction is meant to help stabilize the men after they’re released, since the program also includes counseling, and inmates are driven to their first recovery meeting the day of their release by someone from the sheriff’s office, said Mindy Cady, assistant deputy superintendent for treatment services with the sheriff’s office.

The addiction treatment medications are “scientifically proven” to be effective, Cahillane said. But one hurdle nearly everyone in the room agreed is a barrier to helping addicts recover is the lack of available beds in the area, both for newly released inmates looking for a sober living house and patients being released from detox who need inpatient treatment.

That’s also one reason the first 30 days after being released from incarceration are the most dangerous and carry the greatest risk of overdose: If people go back to the same living situations they were in before, it’s “really difficult” for anyone to maintain their recovery, Cady said.

But according to a study cited by the National Institute on Drug Abuse, 97 percent of inmates who received medication-assisted treatment (specifically methadone) while incarcerated continued with treatment following release.

“The biggest thing that’s changed my life is having a stable environment,” said Carl, a panel speaker and former Hampshire County inmate. He will be celebrating one year of sobriety on Sunday and has been receiving medication-assisted treatment.

Tapestry has been partnering with the sheriff’s office to conduct trainings with inmates, teaching them how to use Narcan and ensuring they’re given free doses to take with them upon their release, said panel speaker Liz Whynott, director of the harm reduction program at Tapestry.

Tapestry also works with people in the community who are struggling with addiction, aiming to build trust by not pushing treatment options on people who don’t want them and instead “meeting people where they are — and not leaving them there,” Whynott said. That can include offering Narcan and counseling and connecting people with recovery services.

Reducing the stigma surrounding addiction would also encourage more people to seek help, as many people who are addicts use in their homes or out of sight due to fear and shame, said Northampton Police Chief Jody Kasper.

“The opioid epidemic does touch us,” Kasper said of the Valley.

The number of overdose calls the police department has received this year has gone down over this time last year — 25 versus 37 — but that may be because people are overdosing in their homes and administering Narcan on their own without calling police, Kasper said. The number of opioid-related deaths this year hasn’t reflected that same drop, she said.

There were eight suspected drug-related deaths last year, and there have been nine so far this year, she said.

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