GREENFIELD — The Franklin County House of Correction has secured a federal license to administer methadone — a drug used to combat opioid addiction — to inmates.
The jail is among the first in the U.S. to provide methadone to inmates, Franklin County Sheriff Chris Donelan said. The jail now has permission to provide all three drugs used to combat opioid addiction: methadone, buprenorphine and naltrexone.
Donelan said the methadone license will help meet a growing need among inmates, nearly 50 percent of whom enter the county jail with an opioid use disorder.
“Methadone is just one of the many tools at our disposal,” Donelan said. “It gives us another tool to help the population.”
The license means inmates who enter the jail using methadone are able to continue their treatment and remain stable, Jail Medical Director Dr. Ruth Potee said. Before last week’s approval, the jail was forced to deny inmates access to methadone, she said.
“People come in and are stable on their methadone, and we have three days to wean them off,” Potee said. “There’s nothing we can do … until now.”
She said it is important to make methadone available, in addition to buprenorphine and naltrexone, because it is the strongest of the three drugs.
Due to its strength, Potee said, methadone may be more effective for those who have been addicted to opioids for a long period of time. It is also relatively cheap: Methadone costs about 20 to 50 cents per dose, compared to buprenorphine, which costs $5 to $7.
“There’s not a single right drug for any person,” Potee said. “You need many options and you can find the one that’s going to work.”
While methadone is stronger than its counterparts, Potee said it is safe to use because patients don’t become addicted to the drug, only dependent on it. Additionally, methadone is pharmaceutical-grade, while the composition of heroin or fentanyl bought on the streets is more ambiguous.
The jail will have an in-house methadone clinic rather than contracting with a vendor, which Potee said will cut some costs. Inmates who choose to use methadone will be brought to a room each day and given a liquid form of the drug to consume, as is the practice with buprenorphine, which the jail was licensed to administer in 2016, Assistant Superintendent Ed Hayes said.
Potee said it is needlessly difficult for jails and patients to access methadone. Federal laws were written in 1972, she said, and are long overdue for an overhaul.
Securing a methadone license was “one of the hardest projects in (her) 50 years on this planet,” she said, adding that news of its approval made for one of the happiest days of her life.
Methadone emerged long before its counterparts, becoming available in the 1950s. Buprenorphine was approved by the U.S. Food and Drug Administration in 2002. Despite methadone’s early arrival, the drug is more regulated than its counterparts, with patients only able to access it at a designated clinic once a day.
In comparison, patients can acquire buprenorphine more freely, at a pharmacy with a monthly prescription.
And to make access to methadone harder, regional clinics are often at capacity, Potee said. Greenfield’s only clinic, Health Care Resource Centers on Shelburne Road, has been full for about three years.
“It should not be this way,” she said. “It is one of the hardest drugs to get access to, yet we know that it is a lifesaving drug.”
While federal laws are dated and, as Potee put it, “lack common sense,” the state has indicated some support for methadone. Last August, the state Legislature passed a law, “an act for prevention and access to appropriate care and treatment of addiction,” that implicitly supported five jails to distribute methadone.
The law required the jails to implement a medication-assisted treatment program — a category that methadone falls under. Potee said the jail would have secured the license regardless of this law, though it does support methadone, among other medication-assisted treatments.
“We were doing it anyway,” Potee said. “The sheriff supports all of this. He’s been a leader nationwide.”