Legislature OKs bill promoting drug-assisted treatment for addicted jail inmates

  • Franklin County Sheriff Chris Donelan, shown in his office at the Franklin County Jail and House of Correction in April 2014, has offered medication-assisted treatment for addicted inmates at the jail since 2016. RECORDER FILE PHOTO

  • Patrick Cahillane, then Hampshire Sheriff's Office assistant superintendent, talks about a study done on replacement housing at the Hampshire Jail and House of Corrections in Northampton in January 2016. GAZETTE FILE PHOTO/KEVIN GUTTING

Staff Writer
Published: 8/1/2018 7:55:09 PM

NORTHAMPTON — Medication-assisted treatment for inmates at the Franklin County Jail since 2016, which is seen as a factor in a 60 percent drop in countywide opioid-related deaths in 2017, is serving as the model for a pilot program included in a bill adopted Tuesday by the state Legislature.

The opioid legislation establishes medication-assisted treatment at five county jails, including the Hampshire County Jail and House of Correction, the Franklin County Jail, and the correctional facilities in Hampden, Middlesex and Norfolk counties.

“This is a bill designed around saving lives,” said Hampshire County Sheriff Patrick Cahillane, who notes that his staff has been working diligently with medical and behavioral specialists to fight the epidemic of addiction to fentanyl, heroin and prescription drugs.

“For us, this is another tool in the toolbox to continue the progress we’ve made, across the commonwealth, but also here in Hampshire County,” Cahillane said.

With medication-assisted treatment, inmates with an addiction will receive drugs such as Suboxone to ease withdrawal symptoms and lower the risk of relapse when they’re released.

The pilot program will allow those with a medication-assisted treatment prescription verified by a physician to continue the treatment regimen while incarcerated.

In addition, medication-assisted treatment options will be made available for inmates for whom such treatment is determined to be medically appropriate by a qualified addiction specialist 30 days prior to their release.

Participants in the pilot program will return to their communities with a coordinated post-release health plan to ensure continuity of care, according to the legislation.

During the pilot program, data will be collected. The information will be given to public agencies so they can better understand what’s working and how to better serve the vulnerable population, as well as to introduce best practices that can be used in the state.

Cahillane said he and his colleagues, including Franklin County Sheriff Christopher Donelan, believe that because there’s a possibility of someone with addictions dying when released, the use at the jail of a tapered regimen of Suboxone or a Vivitrol protocol, both of which are used to treat addiction, will not compromise public safety.

“The purpose is to study the medication levels that may be necessary to curb the epidemic, to try to get people unaddicted,” Cahillane said.

Cherry Sullivan, program director at the county’s opioid prevention coalition Hampshire HOPE, said the legislation could be a game changer.

But legislators also need to make sure that the bill comes with funding.

“The spirit of the legislation is right on, but the state needs to help fund this,” Sullivan said.

There is no money attached to the pilot program yet, though funds may be made available by the time of its scheduled launch in September 2019.

The transition from jail back to the community, Sullivan said, is one of the most high-risk times for those addicted to heroin and other opioids.

“We know it’s a very dangerous time for people who have had opioid addictions,” Sullivan said.

Statistics show that there is a 120 percent increase in the risk of fatal overdoses in the first three months after release, compared to the general population, Sullivan said.

Donelan said he has included medication-assisted treatment in the operating budget for his jail and has prioritized this even if it means running a deficit.

The program in Franklin County has included a licensed person who can properly evaluate each inmate and those who are on pretrial detention, if qualified, will be started on a Suboxone regimen.

Donelan said the jail has seen a decrease in behavioral problems, and prisoners coping better with detoxing, which is never easy.

“When people leave here they are more stable. They have a doctor’s appointment and a treatment regimen,” Donelan said.

It has been worthwhile, he said, to see the 60 percent reduction in opioid deaths in the county last year.

Donelan said he is pleased that the Legislature took the approach of having each county jail use the same techniques, which will allow more accurate information and data collection.

Donelan said he and Cahillane are jointly seeking a $1.5 million federal grant, over a three-year period, that would provide more financial resources for treatment programs and personnel at both the Greenfield and Northampton jails.

Massachusetts Sheriffs’ Association President Peter J. Koutoujian said in a statement that the statewide pilot program will expand upon innovative and nationally recognized work already taking place.

“This approach is balanced, thoughtful and will provide data to drive best practices for us and our colleagues not just locally, but nationally,” Koutoujian said.

In addition to administering medication while individuals are incarcerated, the five sheriffs’ offices will also provide treatment staff and post-release continuity of care to assist those in their recovery. This will be done in collaboration with the Department of Public Health, the Executive Office of Public Safety and Security and MassHealth.

The pilot program will take effect in September 2019, pending the approval of Gov. Charlie Baker, though Cahillane said he is confident that the program may be able to start before then.

The legislation should help reduce police and medical calls related to opioid use, Cahillane said, continuing a trend of jails being on the front line for opioid treatment for much of the past 40 years, with the exception of the 1980s, when the so-called “war on drugs” reduced or eliminated money for treatment.

“When you don’t provide money for treatment, you don’t get good results,” Cahillane said.

Scott Merzbach can be reached at smerzbach@gazettenet.com.

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