Opioid Replacement Option Inside Dutchess County Jail: Suboxone/Methadone/Narcan/Vivitrol!
Opioid Replacement Option Inside Dutchess County Jail: Suboxone/Methadone/Narcan/Vivitrol!
The Issue
Sign this petition if you agree that people with substance abuse issues in the Dutchess County Jail should have access to proven-effective Medication Assisted Treatment (MAT) through Suboxone, Methadone, Narcan, and Vivitrol-- as in Rhode Island and Vermont, and to a lesser extent in two Connecticut jails, Philadelphia jails, and Rikers Island (email countylegislators@dutchessny.gov too!); see:
"How the Smallest State is Defeating America’s Biggest Addiction Crisis: Rhode Island inmates get opioid replacements while they’re locked up and it seems to be keeping them from overdosing when they get out" by Erick Trickey (8/25/18)
https://www.politico.com/magazine/story/2018/08/25/rhode-island-opioids-inmates-219594 (more on this here: http://www.browndailyherald.com/2018/03/14/statewide-program-treats-opioid-use-disorder-jails-prisons/ )
"Opioid Users Are Filling Jails. Why Don’t Jails Treat Them? Getting methadone in jail gave a Connecticut heroin user a firmer foothold in recovery. But fewer than 1 percent of jails and prisons allow it" by Timothy Williams (8/4/17) NYTimes https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html
ACLU, Brennan Center, Vera Institute agree: treatment NOT jail for addicts: https://www.nytimes.com/2017/06/26/opinion/jail-isnt-the-place-to-treat-drug-addiction.html ;
https://www.aclu.org/blog/mass-incarceration/jail-doesnt-help-addicts-lets-stop-sending-them-there ;
http://www.dualdiagnosis.org/jail-time-drug-users/ ;
https://rehab-international.org/blog/imprisonment-harm-help-addicted-offenders ]
[thx also to my wife Laila and fellow Dutchess County Legislators Rebecca Edwards and Frits Zernike for educating me on this issue]
Pass it on.
Joel Tyner 324 Browns Pond Road Staatsburg, NY 12580 joeltyner@earthlink.net 845-464-2245
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Patricia Herring, mother of Matt Herring, recently was a guest on my Saturday morning WHVW 950 AM show, speaking about this-- she said her son Matt's Suboxone was confiscated upon his admittance to the Dutchess County Jail in May 2017-- and then he was immediately put in a cruel and gruesome four days' worth of solitary confinement-- a literal hell on earth (detoxing "cold turkey", as John Lennon shared with us in his song).
See: https://mattherringfoundation.org ; her speech @ 8/25 event here: https://www.facebook.com/joel.tyner/videos/10157708486005744 . Tons of PoJo coverage re: Matt Herring-- but this aspect of his story uncovered(!): https://www.poughkeepsiejournal.com/story/news/local/2018/08/15/overdose-awareness-day-walkway-event-shines-light-without-stigma/992837002/
https://www.poughkeepsiejournal.com/story/news/2018/08/25/year-after-overdose-friends-family-recall-man-who-lit-up-room/1083514002/ ..
Our County Legislature needs to hold a public hearing on what happened to Matt Herring in the Dutchess County Jail—towards the goal of making sure what happened to him never happens to anyone else again.
Patricia Herring (Matt's mother) stated the following publicly in her speech addressing those gathered at the recent Matt Herring Foundation Overdose Awareness Walk at the Walkway Over the Hudson August 25th-- "over eight months in prison my son sat without one day of a program being offered to him for his disease-- not one day-- he sat in Dutchess County Jail in solitary confinement and detoxed-- no medicine no love no support nothing-- solitary confinement for four days detoxing.”
Patricia Herring continued: “This world needs us-- they need us-- we need them. If people could come together today because our sons, daughters, relatives, friends-- whoever it is passed away...then we need to come together for the ones that are working on a path of recovery. They need us; they need compassion; they need us; they need love-- some of them don't have families to go home to. Matthew did-- he was lucky, but a lot of them I've met in the emergency rooms-- they're homeless; I've sat with them. I've waited for them to be discharged; two hours later because there's no bed available in rehab or detox they cannot be discharged to the streets. They need love; they need somebody to sit with them and support them through it all; yes they will relapse-- it's part of their recovery. Understand it; it is part of their recovery."
Sharon Herring (Matt’s grandmother) stated this about Matt in newspaper: “He played football, he played baseball, he was an altar boy, he played lacrosse, he was on a wrestling team. And the whole family went to these events. All of the grandkids looked up to him. He was a beautiful boy.” Then came trouble. Drug paraphernalia found in his car. He was in Dutchess County jail, and then went to Altoona Prison for 8 months over a possession charge as a teenager."
Patricia Herring concluded her speech—“We need to make this the biggest-- I don't know-- other than the epidemic-- we need to make this the biggest path of recovery and show them and everybody that doesn't believe this isn't a disease. Educate them-- educate them what you know, what you have shared with other people-- get out there, tell your neighbors-- I'm telling you people are suffering in silence. I see it people go to Sharon's meetings they want to share their stories. Listen, lend an ear-- lend a hand, volunteer. There are so many organizations, great organizations today-- Matt Herring Foundation always needs volunteers. Look around get the word out-- addiction is real; it's a disease-- it needs to be treated as a disease. It's a health issue-- talk to your representatives of every county of every state; march, do what you can, share your story, don't keep it a secret-- the secrets need to stop-- they need to stop."
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https://www.politico.com/magazine/story/2018/08/25/rhode-island-opioids-inmates-219594
How the Smallest State is Defeating America’s Biggest Addiction Crisis
Rhode Island inmates get opioid replacements while they’re locked up and it seems to be keeping them from overdosing when they get out.
By ERICK TRICKEY
August 25, 2018
CRANSTON, R.I. — By the time police caught Paul Roussell with heroin last summer, the 58-year-old lobster fisherman had been addicted to the drug for almost 10 years. He’d gone from sniffing two bags of heroin a day to 10, then as many as 17. He was running drugs for dealers to afford his habit. “I had already planned that I was going to die,” he says.
He went to prison first. That may have saved his life.
Inside Rhode Island’s Adult Correctional Institutions in this Providence suburb, while facing a felony charge of drug possession with intent to deliver, Roussell was offered a chance to break his addiction through a groundbreaking new program. “I was very surprised to find out that I was able to have methadone in prison,” he says.
Every day while locked up, Roussell drank a 55-milligram dose of methadone, the medicine doctors have used for 50 years to help people get off heroin. “It was very comfortable, very helpful,” says Roussell, a sandy-haired man with deep blue eyes and a handlebar moustache. “I started feeling like my recovery was kicking in.”
Released from prison after three months, Roussell spent eight months in residential treatment. Now he’s living with his parents in Tiverton, his seaside hometown, and working as a landscaper and maintenance man in a business park. His case will be dismissed after his graduation from drug court this month. Every morning, on his way to work, he stops by an opioid treatment clinic for a daily methadone dose. “That keeps me stable,” says Roussell during an interview at Rhode Island’s government campus in Cranston. He’s gone a year without taking heroin. If not for his methadone regimen, he says, “there’d be a good chance of me using.”
Roussell got treatment for his addiction in prison because, two years ago, Rhode Island decided to do something no other state has done. In 2016, it began offering its prison inmates all three medications approved to treat opioid addiction: methadone, Suboxone, and Vivitrol . About 350 Rhode Island prisoners each month take one of the three medicines. Crucially, they continue their treatment after their release, usually through the state’s Medicaid program, when they’re at the greatest risk of a relapse and a fatal overdose. It’s among the opioid crisis reforms championed by Governor Gina Raimondo in response to Rhode Island’s overdose death rate, ninth-highest among the 50 states.
The $2 million program has already saved lives, state officials say. In the first half of 2016, 26 recently incarcerated people died of drug overdoses in Rhode Island. In the same period last year, only nine did. That’s 61 percent fewer fatalities.
“The magnitude of that drop in mortality is almost unheard of in public health,” says Dr. Josiah Rich, a professor at Brown University’s medical school and co-director of Rhode Island’s Center for Prisoner Health and Human Rights. It’s a small study based on overdose death records, not a randomized test controlled for other possible causes. Still, the results, published in the American Medical Association journal JAMA Psychiatry in February, suggested that the medication-assisted treatment program prevented one overdose death for every 11 inmates it treated.
Rhode Island’s approach is rare in the nation’s prison systems, most of which offer no medication-assisted treatment. Roughly 400,000 inmates nationwide might benefit from it: 20 percent of the nation’s 2.3 million inmates are incarcerated on drug offenses, and estimates of regular opioid use or addiction among inmates range from 17 percent a decade ago to 25 percent now. Some states offer inmates Vivitrol, an opioid blocker. But because methadone and Suboxone are also opioids, corrections officials usually ban them as contraband, concerned that inmates might divert to other inmates.
Doctors and public-health officials consider medically-assisted treatment the standard of care for opioid addiction. But it suffers from a widespread belief, even in parts of the recovery community, that it is simply “substituting one drug for another.” The Trump administration has given mixed signals on the issue. In May of last year, former Health Secretary Tom Price told a reporter, “If we just simply substitute buprenorphine or methadone or some other opioid-type medication for the opioid addiction, then we haven't moved the dial much.” Price later backtracked, saying he supported some MAT programs. Trump’s opioid policy, released in March, supports MAT for criminal offenders.
The distrust of medication-assisted treatment in prisons is starting to change, especially in New England, home to five of the 11 states with the highest fatal overdose rates. Vermont and Connecticut operate smaller medication-assisted treatment programs for some inmates, and on August 9, Massachusetts Governor Charlie Baker signed a bill that expands treatment in the state’s prisons. Advocates in Rhode Island say they hope their state’s approach becomes a model for the nation.
“We’re in the middle of a horrible epidemic,” says Rich. “There’s no reason this can’t be done just about anywhere else.”
***
When Gina Raimondo was running for Rhode Island governor in 2014, the opioid epidemic wasn’t a campaign issue. The candidates didn’t run on it, and it didn’t come up in their debate. But it did come up when she spoke to voters. “I would hear about it constantly, mostly from parents who’d lost kids,” she said in a recent interview.
Now, Rhode Island’s prison treatment program has emerged as the most innovative part of Raimondo’s anti-overdose strategy. It’s an accomplishment she’s talking about as she runs for re-election in November, in a state with a population of 1 million that’s seen more than 1,000 overdose deaths since 2015.
“We’re the only state in America that has a state-supported, state funded, full range of medically assisted treatment in the prisons,” Raimondo told a gathering of Rhode Island public health professionals at the Community Overdose Engagement Summit in Warwick, R.I., in June. “And it is working.”
Soon after she took office, Raimondo created an overdose prevention task force. Its expert advisers included public-health advocates and officials who had wanted to get a methadone program going in Rhode Island’s prison system for decades.
“It met with a lot of resistance over the years,” recalls Rich, a task force advisor, who wrote unsuccessful grant applications for a prison methadone program in Rhode Island 20 years ago. “People who have this disease are thought to be somewhat subhuman.”
Once, in the 1990s, Rich got into a disagreement with a prison nurse over whether to help an inmate suffering from drug withdrawal. “I said we should give him medication to make him feel better,” he recalls. “She said, ‘No, we don’t do that. He’s supposed to suffer. That way he won’t come back again.’”
“This is something I’ve wanted to do since I started here 20 years ago,” says Dr. Jennifer Clarke, the medical programs director for Rhode Island’s corrections department. “Once the task force was together, and saw corrections as a priority, we were already ready to come up with a plan.”
Clarke and the other advisers asked for a broad program that would offer medication-assisted treatment (MAT for short) to three types of inmates.
Inmates who come into the corrections system with a doctor’s prescription for MAT are no longer taken off it. Since the 1990s, Rhode Island prison medical staff had been giving methadone patients a week’s worth of the drug, then tapering them off it—a standard practice in corrections systems around the country, Clarke says. “I think that’s where we’re doing the greatest damage to communities, by taking people off of MAT,” she says.
New inmates who are withdrawing from opiates go straight into an induction program —a few days of methadone or Suboxone to ease withdrawal symptoms. “[We] start people on treatment right when they come in the door,” Clarke says. This part was simple to implement statewide, because Rhode Island has no county jails. The smallest state in the union, just 37 miles wide and 48 miles long, it has a combined prison-and-jail system in Cranston with a single medical staff.
Inmates with histories of addiction can choose to go on methadone, Suboxone or Vivitrol a few months before their release. “This was, I think, the most difficult for people to accept,” says Clarke, “that we were taking people who’d been off opiates for years and putting them back on MAT.” But just-released former inmates are at the highest risk of dying of an overdose. They’ve lost their physical tolerance for opioids, but they haven’t lost their cravings.
“It’s the same thing as smoking,” says Clarke. “[If] somebody’s here for five, 10 years, it doesn’t mean they’re not craving a cigarette the whole time. They haven’t actually quit. They’re not actually in recovery. They’re just away from the substance.”
The task force created a four-point plan: better prescription monitoring, more access to the overdose-reversing drug naloxone, more peer-recovery programs and more medication-assisted treatment, in prison and across the state.
The prison MAT program faced skepticism, but not vocal opposition, says Raimondo. Legislators pressed her to make the case for the $2 million program. Among the public, “There was a little pushback that these are people in prison, and why are we giving health care to prisoners?” says Raimondo. Prisoners are “much, much more likely to overdose and die when they come out,” she argued, “so, for this much money, we could save lives and save money.” The legislature included the funding in the state’s 2017 budget, with little to no opposition. Raimondo says the consensus reflects how the state has come together to deal with the opioid epidemic, which she calls Rhode Island’s biggest public-health crisis.
“We have a worse problem in Rhode Island than other states,” she says. “People realize that.”
***
For inmates with chronic pain and opioid addictions, methadone and Suboxone can offer a path out of vicious cycles.
Bill Fox, 53, has spent 26 years in Rhode Island’s prison system, for crimes ranging from felony domestic violence to forgery. He went on Suboxone three months before his release from prison this March. Now, he’s living at a sober house in Providence and receives Suboxone at a state-funded treatment center. He takes Suboxone three times a day, letting a small orange strip containing the drug dissolve under his tongue.
“It keeps me off any of the hard drug stuff,” Fox says. “It regulates my life in a roundabout way. It keeps me in check: Here’s something for your pain, and everything else falls into place.”
Fox says he first took an opioid painkiller at age 12, for fun, and first snorted heroin at 18 or 19. He says he used prescription opioids and then heroin after several injuries, including a three-story fall 20 years ago when he was capping a chimney and the staging gave out. Throughout a nearly hour-long interview, Fox rubs and presses his right knee to ease its ache.
“The painkillers, they ruined my life,” he says. He says he’d often con or bully people to get money for OxyContin or heroin. If not for Rhode Island’s MAT program, Fox says, “I’d be back in jail.”
Prisoners’ cravings for drugs will often get worse as their release date approaches, says Linda Hurley, president and CEO of CODAC Behavioral Healthcare, a state-funded nonprofit that administers the MAT program before and after prison.
“[They have] dreams about using substances, how it’s going to feel,” Hurley says. They catch themselves starting to plan for drug-seeking once they’re out. Afraid, they’ll turn to the MAT program for help. “They’re no longer physically dependent on the substance, but the brain hasn’t healed,” Hurley says. “They’re still addicted.” Without MAT, they’re extremely vulnerable to a fatal overdose. In the first half of 2016, 15 percent of the people who died of an overdose in Rhode Island—26 out of 179—had been in Rhode Island’s corrections system a year before. Ten died within a month of their release. “When they get out, they don’t have the same tolerance anymore, but the brain wants the same amount,” Healey says.
Other states with prison MAT programs, including West Virginia, Kentucky, and Massachusetts, offer only Vivitrol injections, just before inmates are released. But in Rhode Island, where inmates choose which medication they’ll go on, only about 1 percent choose Vivitrol. About 60 percent choose methadone, while 39 percent choose Suboxone.
Vivitrol blocks opioids from producing a high. But it doesn’t help with withdrawal symptoms, so it isn’t appropriate for newly incarcerated inmates. Unlike methadone and Suboxone, Vivitrol doesn’t relieve pain, and its users have to turn to non-opioid analgesics for pain relief.
“It’s a great medication if the patient wants it and if it addresses [their] symptoms,” says Clarke, the prison medical director. “Like so much else in medicine, the best medicine for an individual is one they’re going to stick with and take.”
Michael Manfredi chose Vivitrol in 2016 on a fellow inmate’s recommendation. He was finishing a four-year prison stint for robbery, assault and breaking and entering. “Every time I was incarcerated, it was due to my addiction,” says Manfredi, 55, who started shooting heroin at 15 and first went to prison, for robbery, at 18. “The previous couple of times that I went, they just sent you out with nothing, no maintenance,” he says.
“Vivitrol for me was a godsend,” says Manfredi. “I’ve lost the desire to use, lost the urges to use, the cravings.” He goes to a center in Providence every 28 days to get a Vivitrol injection in his hip and to meet with a team of counselors, including social worker and a psychiatrist. He also goes to several peer-help meetings a week. “I had to work the program,” he says. “Just getting my shot wasn’t good enough.”
Two years after Manfredi’s release, he works for a construction company and lives with his adult daughter. “My daughter finally can trust me again,” says Manfredi, who has a long, thin face and who shakes with emotion as he tells his story. “She can go out of the house and not worry I’m going to take anything and sell it.”
Vivitrol “changed my life,” Manfredi says. “I didn’t think I could be a normal person.”
***
Rhode Islanders say they hope other states use their prison program as a model for fighting addiction.
“Other governors have said, ‘Hey, that seems to be working, tell me about it,’” says Raimondo. At last year’s National Governors Association conference, she talked up the program while on a panel about the opioid epidemic. “After that, a lot of them came up to me and said, ‘We want to do that.’”
The program’s supporters have plenty of advice for other states. “You shouldn’t even think about doing a program like this in a correctional setting if you don’t connect with [inmates] after release,” says Rich, the doctor and prisoners’ health advocate.
Setting up a system to continue ex-inmates on treatment would be a bigger challenge in big states. “If somebody is released in Rhode Island, and they’re a Rhode Islander, they’re probably no more than 40 miles away,” says Clarke.
Corrections staff have to guard against prisoners diverting the medicine to other prisoners under threats or coercion. Methadone and Suboxone are mild opiates that usually don’t trigger a high at prescribed doses, says Rich, but they can be abused. “We worry people on treatment may be manipulated,” Clarke says. So the prison administers Suboxone in dissolvable strip form, because tablets, though cheaper, take longer to dissolve and are easier to divert. Prisoners on methadone are required to drink water and eat saltines after drinking their dose, so their fellow prisoners know they can’t spit up the medication later.
Suboxone is among the drugs commonly smuggled into prisons, often during prison visits. Prisons across the country have tightened their inspections of incoming mail to catch Suboxone secreted in letters and envelopes. In Ohio prisons, where five percent of inmates tested positive for drugs in 2016, Suboxone ran a close second to marijuana as the most popular contraband drug.
Rhode Island’s corrections department hasn’t yet sifted its contraband records to try to measure potential diversion, but Clarke says one warden has told her the amount of contraband Suboxone coming into the prisons may be dropping, “because people are being treated.”
Outside Rhode Island, acceptance of medication-assisted treatment for inmates is slowly growing. New York City has had a methadone program at its Rikers Island jail complex since 1987, though inmates likely to be sent to state prison aren’t eligible for maintenance therapy. Philadelphia jails have a methadone program too. Vermont has a MAT program for prison inmates who were on methadone or Suboxone before their arrests, as do two Connecticut jails. Massachusetts will do the same next year. On August 9, Governor Baker signed a bill that will create a similar program for existing MAT patients in several state prisons.
Trump’s opioid initiative, announced in March, pledges to screen all federal inmates for opioid addiction when they enter prison, and facilitate Vivitrol treatment if they’re released to residential community centers. It also called for increased federal support for state and local drug courts to provide evidence-based treatment to addicted offenders.
Raimondo – who faces a tough re-election race in November -- says the Trump Administration isn’t doing enough. “Like so much of what they do, they don’t have any serious policy,” she says. “If the president were really serious about this, there would be federal funding behind it.
“Our medically-assisted treatment program—that could easily be federally funded,” Raimondo says. “It could be done in 50 states tomorrow. For a small investment, we could save thousands, tens of thousands of lives.”
Erick Trickey is a writer in Boston.
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https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html
Opioid Users Are Filling Jails.
Why Don’t Jails Treat Them?
Getting methadone in jail gave a Connecticut
heroin user a firmer foothold in recovery. But
fewer than 1 percent of jails and prisons allow it.
By TIMOTHY WILLIAMS AUG. 4, 2017
NEW HAVEN — When Dave Mason left jail in October 2015 after his 14th criminal conviction, the odds were good that he would soon end up dead.
A man with a longtime heroin addiction, Mr. Mason was entering one of the deadliest windows for jailed users returning to the streets: the first two weeks after release, when they often make the mistake of returning to a dose their body can no longer handle.
Standing outside the New Haven Correctional Center, clutching his few belongings in a brown paper bag, Mr. Mason appeared precariously close to taking that path. His ride never showed up. He had no money, no contact with his family and nowhere to live.
But instead of panhandling for cash to score drugs, he went to a methadone clinic, determined to stay clean.
Methadone was not a new thing for Mr. Mason, 43. He had been on it before he went to jail for cashing forged checks. But it is almost always banned in jail, increasing the chances of relapse. Of the nation’s 5,100 jails and prisons, fewer than 30, according to the federal Bureau of Justice Assistance, offer opioid users the most proven method of recovery: administering methadone or buprenorphine.
Mr. Mason, though, had been allowed to take his daily dose, in a fledgling program that helped him continue what he says has been his longest period off heroin since his teens.
“It is the key to my success,” he said. “It did what it was supposed to do. It kept me clean.”
For more than a year, the PBS series “Frontline” and The New York Times followed 10 newly released prisoners in Connecticut, including Mr. Mason, as they tried to start over. Though the stories were about the criminal justice system, they were also, inevitably, about addiction — three out of four inmates in Connecticut have a drug or alcohol problem, according to the Department of Correction, and the number who use opioids has soared.
For these 10, there were many setbacks, and what counted as success was modest. Mr. Mason met up with his girlfriend, Dani Herget, who at the time also used heroin; slept outdoors; panhandled for money; and used a wide variety of street drugs. Twice he was ordered into treatment, and once he was sent back to jail. Ultimately, he reunited with Ms. Herget, 21.
But despite his self-destructive tendencies, he says he stayed off heroin and has ultimately been able to moderate his use of other drugs.
Though limited in size, the methadone treatment program is one of numerous changes Connecticut has made to help inmates successfully re-enter society. But for most jails and prisons, such programs are out of the question. Much of the criminal justice system still takes a punitive approach to addiction. Many who work in corrections believe, incorrectly, that treatments like methadone, itself an opioid, allow inmates to get high and simply replace one addiction with another. And many officials say they have neither the money nor the mandate to provide the medications.
“The best way to not get addicted to opioids is to never use them,” said James M. Cummings, sheriff of Barnstable County in Massachusetts, who opposes methadone in jails despite a sharp rise in addiction and overdoses there.
But maintenance treatments like methadone, if uninterrupted, are proven to reduce arrests and increase employment, and for many with addiction are the only thing that works. In July, a White House commission on opioid addiction called for increasing inmates’ access to addiction medication.
Dr. Kathleen Maurer, director of health services for Connecticut’s corrections department, said it was critical for jails and prisons to treat opioid addictions like chronic diseases, including providing medicine.
“We don’t take away people’s insulin or their asthma inhalers,” she said. “Why should we take away their methadone?”
In the New Haven jail, 35 inmates stand in line every day at 12:30 p.m. to drink the contents of a plastic cup containing a green, bitter fluid, followed by a swallow of a sweet orange drink to wash it down. A corrections officer shines a flashlight beam into their mouths as they leave the room to ensure that they have nothing hidden there.
With this dose of methadone, individually calibrated to alleviate cravings without producing a high, these inmates have been spared the torment of detox — a painful process that includes diarrhea, insomnia, severe cramping and hallucinations. But more important, they have less danger of relapse.
Methadone and Suboxone, a combination of buprenorphine and naloxone, work by reducing cravings and preventing withdrawal symptoms. Because they activate opioid receptors in the brain, both drugs can cause a high in large enough doses. Suboxone is already commonly smuggled into lockups, whether to get inmates high or help them avoid withdrawal.
Though people do not die from opioid withdrawal, without proper care they can die from related effects like dehydration. There have been several such deaths, as well as dozens of overdose deaths, in jails in recent years.
Few studies have measured the outcomes of jail-based methadone treatment. But a 2001 study at Rikers Island, which started one of the country’s first jail-based methadone programs in 1987, found that participants were less likely to commit new crimes and more likely to continue treatment. And a 2014 Australian study found fewer overdose deaths after release.
In New Haven, Mr. Mason, who started injecting heroin at age 17, represents an unexpected success, officials say, given the length and severity of his addiction.
Tall and lean with missing front teeth and a limp, Mr. Mason avoids giving detailed answers to questions about his life and frequently contradicts himself. He is chronically homeless and has become an expert in surviving on the street, subsisting for years by panhandling and theft. He knows where to go for free meals and where on the street to buy benzodiazepines to combat his anxiety. He has committed to memory the schedules of certain police officers who will arrest him at the slightest provocation.
He has been in jail more times than he remembers — for credit card theft, shoplifting and multiple probation violations, among other charges.
But he said being able to continue using methadone while in jail had helped convince him that it was time to try to change.
“Everybody has to hit a turning point where you can’t picture your life with or without drugs,” he said. “You’re at this spot. You know you can’t use anymore, but you don’t know how not to use anymore.”
Connecticut jails were not even allowed to dispense methadone in 2013, when Dr. Maurer, the prison medical director, saw a report that drug overdose deaths in the state had more than doubled over the previous six years. Forty percent of the victims were former inmates.
Dr. Maurer spent months helping persuade state lawmakers to change the law. Then she had to convince the warden.
Like many jail officials, Jose A. Feliciano Jr., the New Haven jail warden, was skeptical. “I thought, ‘That’s another substitute for heroin,’” he said.
Jose A. Feliciano Jr., the warden of the New Haven jail: “I can tell you the climate around these people is better than it had been before,” he says of the prison’s heroin-addicted inmates after the methadone program’s start.
But even he had been personally touched by the problem: Two of his relatives had been heroin addicts who died of AIDS. And one of his three children is recovering from addiction.
“To say that’s something that didn’t influence me would be a lie,” he said. “Not until it impacts people close to you do you understand. It’s incredible how quickly it can overtake a person.”
Initially, Mr. Feliciano opposed the disruption that methadone handouts would surely cause. “But the more I talked to Dr. Maurer, the better I understood that it is an opportunity to let them live a clean life,” he said. “These individuals at some point in time are going to leave these walls. When people run out of drugs, they’re going to start stealing, committing crime.”
Officials say the treatment has shown promise in reducing fatalities and making inmates more likely to continue treatment once they are released, and Mr. Feliciano said the behavior of addicted inmates improved.
“I can tell you the climate around these people is better than it had been before,” Mr. Feliciano said.
But attitudes have not completely shifted, and methadone is still viewed as a privilege. Inmates can be kicked out of the program for any disciplinary infraction.
Karen Martucci, a spokeswoman for the Department of Correction, said the state had a responsibility to maintain order and enforce rules. “It’s also important to recognize that methadone has a contraband value in a correctional environment,” she said.
When Mr. Mason landed back in jail on a probation violation, he got in a fight and was rejected by the program, forcing him into methadone withdrawal, considered far more agonizing than heroin withdrawal.
“It should be illegal,” he said. “They shouldn’t be able to put a dude through that.”
Severe budget shortfalls have limited the program to just two of the state’s 15 jails. It is open only to those who were already taking methadone when they were arrested.
And unlike Rhode Island and Vermont, which offer methadone and Suboxone, Connecticut offers only one option, which may not work for everyone.
A growing number of jails, especially in rural areas, have opted to treat inmates not while they are in jail, but on the way out, giving them a one-time shot of a newer medication, Vivitrol, as they are released. Vivitrol, which unlike methadone and Suboxone is not a narcotic and has no street value, blocks opioid receptors in the brain, making getting high nearly impossible. It is far more expensive, and far less proven, than methadone and Suboxone, but its manufacturer often gives it to jails free. Its effect lasts about a month.
Even in Connecticut, inmates say, prejudices against methadone persist.
“The D.O.C. hates the methadone program,” a friend and jailmate of Mr. Mason’s said when they met on the street and compared notes. “They make fun of us and stuff. They’re like, ‘Oh, you junkies, go get your juice.’ Then they put all our names on the board so everybody in the dorm knows who’s on methadone.”
But for the first time in years, Mr. Mason has allowed himself to envision a future free of heroin — and along with it, the hustles and thefts necessary to support an addiction.
After his release — and over a period of several months — Mr. Mason painstakingly reduced his methadone intake to the point that he has been able to switch to the less powerful buprenorphine. The new medication, he said, allows him to think more clearly.
He has never held a steady job, and his days are often spent watching hours of television with Ms. Herget. He takes medication for severe anxiety and other mental health problems.
But he has begun to talk of finding work, saying he would like to become a drug counselor.
Sometimes, he expresses reservations about a relationship with another recovering addict.
Mr. Mason goes to rehab, but must leave Ms. Herget behind.
“I just don’t want to be with a wife who shoots dope,” he said. “I’m a heroin addict. It’ll take like that for me to fall in love with it again. And then, nothing else matters.”
But Ms. Herget’s pull on him is strong, and at other times, he speaks of marriage.
“I’m excited to live a decent life, be the man Dani needs and deserves,” he said. “I’m grateful to be there for my girlfriend. I can spare her 20 years of living hell.”
Matthew O’Neill and Jeff Arak contributed reporting from Connecticut and New York City.
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https://www.nytimes.com/2018/09/17/opinion/drugs-dea-defund-heroin.html
The Drug Enforcement Administration has proved itself incompetent for decades.
By Leo Beletsky and Jeremiah Goulka
Professor Beletsky is the faculty director of Northeastern University’s Health in Justice Action Lab, where Jeremiah Goulka is a senior fellow.
Sept. 17, 2018
[excerpt here below]
We urgently need to rethink how our nation regulates drugs. What should our goals be? How can we design institutions and performance metrics to achieve them?
The answers lie at the local and state levels. In Rhode Island, opioid overdoses are declining because people behind bars have access to effective treatment. Massachusetts has deployed drop-in centers offering treatment, naloxone and other services. San Francisco and Seattle are planning to open safe consumption spaces which show tremendous promise as a tool to reduce overdose deaths and other drug-related harm. But the D.E.A. and its institutional parent, the Justice Department, stand in the way of some of these experiments.
We ought to reinvent the Drug Enforcement Administration.
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[recall below sent out to last fall-- still very much pertinent re: Matt Herring & us all!]
Fact: as of Oct. 25, 2017 (and this has been true just about every time I've researched this over past few years) there were 33 nonviolent drug addicts (not charged with any aggressive/violent act or drug-dealing/selling-- 25 of whom not even sentenced yet) locked up behind bars in the Dutchess County Jail-- at a cost of $125 per day to local taxpayers no less-- Jonathan (587 days), Alaric (259 days), Savon (120 days), Douglas (171 days), Spencer (160 days), Sarah (149 days), Maurice (136 days), Romairo (150 days), Elijah (125 days), Jaroslaw (58 days), Carl (64 days), Nicole (89 days), Michael (68 days), Eric (64 days), Leta (35 days), Rodney (48 days), Thomas (38 days), Timothy (34 days), Randy (28 days), Shaonna (28 days), Brett (27 days), Zachary (27 days), Manoj (24 days), James (20 days), Bleron (14 days), Curtis (12 days), William (11 days), Rahmel (6 days), Kaitlin (1 day), Halley (1 day), and Julian (1 day)-- a total of 2552 days of incarceration for those 33 nonviolent drug addicts over the last 587 days-- at a cost of $125 per day equals $319,000 spent-- despite rhetoric we've been hearing for years from Molinaro/GOP re: Crisis Stabilization Center about diverting nonviolent drug addicts from incarceration locally...not outraged?....sorry peeps you're not payin' attention-- email all 25 of us at countylegislators@dutchessny.gov-- and pls help get these facts into local papers by writing letters to the editor! (unless you like incarcerating drug addicts); recall how at big forum on this in 2016 mantra repeated over and over again in front of hundreds @ Family Partnership Center was this-- "addiction is a disease not a crime".....(so why is it that there are dozens of nonviolent addicts in our jail?):
http://www.poughkeepsiejournal.com/story/news/local/2016/09/11/heroin-opiates-addiction-faces-of-loss/89540472/ (needed: YOU to speak truth to power on this!)]
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https://www.nytimes.com/2017/06/26/opinion/jail-isnt-the-place-to-treat-drug-addiction.html
Jail Isn't the Place to Treat Drug Addiction
New York Times JUNE 26, 2017
To the Editor:
In "A New Kind of Jail for the Opiate Age" (Sunday Review, June 18),
Sam Quinones argues for in-jail treatment as a solution to rising opioid use.
We should certainly improve treatment in jails. But by focusing on
building drug treatment infrastructure inside the criminal justice system,
we further institutionalize its placement there. This reinforces the belief
that people battling addiction deserve punishment - undoing years of progress to understand addiction as a health issue.
Any contact with our justice system affects people beyond their time behind
bars. Incarceration or a criminal conviction should not be a prerequisite to
treatment. In many states, possession of opioids remains a felony. We should
divert these people away from incarceration and into treatment programs instead.
Jails and prisons have a notoriously bad track record of providing health
services. They are built to punish and isolate, not rehabilitate. The quality
and availability of treatment in them vary greatly. In responding to addiction,
we should not mistake a short-term solution for an indispensable one.
INIMAI CHETTIAR, GRAINNE DUNNE
NEW YORK
The writers are, respectively, director of the Justice Program at the Brennan
Center for Justice at the N.Y.U. School of Law and a research associate in the program.
https://www.brennancenter.org/publication/how-many-americans-are-unnecessarily-incarcerated
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To the Editor:
Using jail as a program for drug users is a symptom of another urgent problem: mass incarceration, which increasingly takes the form of an overcrowded rural or small county jail.
In 2010, Kenton County, Ky., built a very large jail for a county its size,
equivalent to New York City's tripling the size of Rikers Island to 30,000 beds.
Kenton's new jail is overcrowded, costs the county more than expected, and is soaking up tax dollars that could be used for innovative, community-based
drug treatment that would look much more affordable if the jail weren't so large.
When you have a hammer, everything looks like a nail. But there is another option: Downsize the jail and invest in community-based treatment so that the criminal justice system does not become the de facto public health strategy in rural places.
JACOB KANG-BROWN, NEW YORK
The writer is a senior research associate at the Vera Institute of Justice.
http://www.safetyandjusticechallenge.org/wp-content/uploads/2015/01/incarcerations-front-door-report.pdf
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https://www.aclu.org/blog/mass-incarceration/jail-doesnt-help-addicts-lets-stop-sending-them-there
Jail Doesn't Help Addicts. Let's Stop Sending Them There.
By Kara Dansky, Senior Counsel, ACLU Center for Justice
OCTOBER 17, 2014 | 11:17 AM
Misti Barrickman has scoliosis. Since she was a teenager, it's been debilitating. It hurt to lie down. It hurt to stand up.
She started taking Oxycontin to help with the pain and became addicted. She came to Seattle to find large quantities of the drug. Unable to find it and feeling increasingly desperate, Misti tried what was readily available: heroin. For the next seven years, she struggled with addiction. She lived between a tent and a jail cell, racking up charges for possession and prostitution.
Almost 30,000 people were arrested for drugs in New York in 2012. Over 117,000 people were arrested for drugs in California in the same year. Nearly 10,700 people were arrested for drugs in Washington that year.
Some of these people, like Misti, have been arrested multiple times - their addictions haven't been helped by stint after stint behind bars. Too often, the cycle just keeps repeating itself.
Seattle is trying something different.
Since 2012, the city's Law Enforcement Assisted Diversion program (LEAD) cuts out the criminal justice middleman. Instead of jailing people struggling with addiction, officers connect people directly with the treatment and services that can actually help them get sober.
Instead of wasting time and money with a court hearing and saddling people with a criminal record before they can access treatment and services, LEAD doesn't waste time. And unlike drug courts, LEAD participants who relapse are not threatened with jail time and expulsion from the program.
For the people we interviewed, the program is working. Misti's been sober now for two years. She no longer lives in a tent, and her pain is under control. She is in school. The latest video in our "OverCriminalized" series - produced in partnership with Brave New Films and The Nation - tells Misti's story and the story of others whose lives have improved after police took them to services, not to jail.
For decades, this country has been waging a failed war on drugs. Drug use hasn't gone down. Drugs are just as available as they used to be. Instead of solving our drug problem, we've become a society that seemingly disregards millions of lives - particularly the lives of black and brown people.
Although the majority of people who use and deliver drugs in Seattle are white, the black drug arrest rate was 13 times higher than the white drug arrest rate in 2006. Aggressive over-policing has ravaged communities. Large swaths of the population have been locked up. And billions of dollars have been wasted that could have been much better spent on interventions that could have actually changed the course of people's lives.
Drug addiction has become one of the many social problems that we've relegated to the criminal justice system. But as with homelessness and mental illness, handcuffs and jail cells haven't made things better and have cost much more than the treatment and services that can. It doesn't have to be this way. America can safely reduce our reliance on incarceration. Several states have reduced their prison populations while crime rates have dropped.
Addiction should not be a crime.
"OverCriminalized," a new series produced Brave New Films in partnership with the ACLU and The Nation, profiles three promising and less expensive interventions that may actually change the course of people's lives. It's time to roll back mass criminalization and focus on what works.
[note: not just Seattle-- Albany has LEAD program too; we need LEAD here(!):
http://www.timesunion.com/local/article/Albany-launches-LEAD-diversion-program-7219908.php ;
https://www.seattletimes.com/seattle-news/crime/lead-program-for-low-level-drug-criminals-expands-to-east-precinct/ ]
96
The Issue
Sign this petition if you agree that people with substance abuse issues in the Dutchess County Jail should have access to proven-effective Medication Assisted Treatment (MAT) through Suboxone, Methadone, Narcan, and Vivitrol-- as in Rhode Island and Vermont, and to a lesser extent in two Connecticut jails, Philadelphia jails, and Rikers Island (email countylegislators@dutchessny.gov too!); see:
"How the Smallest State is Defeating America’s Biggest Addiction Crisis: Rhode Island inmates get opioid replacements while they’re locked up and it seems to be keeping them from overdosing when they get out" by Erick Trickey (8/25/18)
https://www.politico.com/magazine/story/2018/08/25/rhode-island-opioids-inmates-219594 (more on this here: http://www.browndailyherald.com/2018/03/14/statewide-program-treats-opioid-use-disorder-jails-prisons/ )
"Opioid Users Are Filling Jails. Why Don’t Jails Treat Them? Getting methadone in jail gave a Connecticut heroin user a firmer foothold in recovery. But fewer than 1 percent of jails and prisons allow it" by Timothy Williams (8/4/17) NYTimes https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html
ACLU, Brennan Center, Vera Institute agree: treatment NOT jail for addicts: https://www.nytimes.com/2017/06/26/opinion/jail-isnt-the-place-to-treat-drug-addiction.html ;
https://www.aclu.org/blog/mass-incarceration/jail-doesnt-help-addicts-lets-stop-sending-them-there ;
http://www.dualdiagnosis.org/jail-time-drug-users/ ;
https://rehab-international.org/blog/imprisonment-harm-help-addicted-offenders ]
[thx also to my wife Laila and fellow Dutchess County Legislators Rebecca Edwards and Frits Zernike for educating me on this issue]
Pass it on.
Joel Tyner 324 Browns Pond Road Staatsburg, NY 12580 joeltyner@earthlink.net 845-464-2245
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Patricia Herring, mother of Matt Herring, recently was a guest on my Saturday morning WHVW 950 AM show, speaking about this-- she said her son Matt's Suboxone was confiscated upon his admittance to the Dutchess County Jail in May 2017-- and then he was immediately put in a cruel and gruesome four days' worth of solitary confinement-- a literal hell on earth (detoxing "cold turkey", as John Lennon shared with us in his song).
See: https://mattherringfoundation.org ; her speech @ 8/25 event here: https://www.facebook.com/joel.tyner/videos/10157708486005744 . Tons of PoJo coverage re: Matt Herring-- but this aspect of his story uncovered(!): https://www.poughkeepsiejournal.com/story/news/local/2018/08/15/overdose-awareness-day-walkway-event-shines-light-without-stigma/992837002/
https://www.poughkeepsiejournal.com/story/news/2018/08/25/year-after-overdose-friends-family-recall-man-who-lit-up-room/1083514002/ ..
Our County Legislature needs to hold a public hearing on what happened to Matt Herring in the Dutchess County Jail—towards the goal of making sure what happened to him never happens to anyone else again.
Patricia Herring (Matt's mother) stated the following publicly in her speech addressing those gathered at the recent Matt Herring Foundation Overdose Awareness Walk at the Walkway Over the Hudson August 25th-- "over eight months in prison my son sat without one day of a program being offered to him for his disease-- not one day-- he sat in Dutchess County Jail in solitary confinement and detoxed-- no medicine no love no support nothing-- solitary confinement for four days detoxing.”
Patricia Herring continued: “This world needs us-- they need us-- we need them. If people could come together today because our sons, daughters, relatives, friends-- whoever it is passed away...then we need to come together for the ones that are working on a path of recovery. They need us; they need compassion; they need us; they need love-- some of them don't have families to go home to. Matthew did-- he was lucky, but a lot of them I've met in the emergency rooms-- they're homeless; I've sat with them. I've waited for them to be discharged; two hours later because there's no bed available in rehab or detox they cannot be discharged to the streets. They need love; they need somebody to sit with them and support them through it all; yes they will relapse-- it's part of their recovery. Understand it; it is part of their recovery."
Sharon Herring (Matt’s grandmother) stated this about Matt in newspaper: “He played football, he played baseball, he was an altar boy, he played lacrosse, he was on a wrestling team. And the whole family went to these events. All of the grandkids looked up to him. He was a beautiful boy.” Then came trouble. Drug paraphernalia found in his car. He was in Dutchess County jail, and then went to Altoona Prison for 8 months over a possession charge as a teenager."
Patricia Herring concluded her speech—“We need to make this the biggest-- I don't know-- other than the epidemic-- we need to make this the biggest path of recovery and show them and everybody that doesn't believe this isn't a disease. Educate them-- educate them what you know, what you have shared with other people-- get out there, tell your neighbors-- I'm telling you people are suffering in silence. I see it people go to Sharon's meetings they want to share their stories. Listen, lend an ear-- lend a hand, volunteer. There are so many organizations, great organizations today-- Matt Herring Foundation always needs volunteers. Look around get the word out-- addiction is real; it's a disease-- it needs to be treated as a disease. It's a health issue-- talk to your representatives of every county of every state; march, do what you can, share your story, don't keep it a secret-- the secrets need to stop-- they need to stop."
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https://www.politico.com/magazine/story/2018/08/25/rhode-island-opioids-inmates-219594
How the Smallest State is Defeating America’s Biggest Addiction Crisis
Rhode Island inmates get opioid replacements while they’re locked up and it seems to be keeping them from overdosing when they get out.
By ERICK TRICKEY
August 25, 2018
CRANSTON, R.I. — By the time police caught Paul Roussell with heroin last summer, the 58-year-old lobster fisherman had been addicted to the drug for almost 10 years. He’d gone from sniffing two bags of heroin a day to 10, then as many as 17. He was running drugs for dealers to afford his habit. “I had already planned that I was going to die,” he says.
He went to prison first. That may have saved his life.
Inside Rhode Island’s Adult Correctional Institutions in this Providence suburb, while facing a felony charge of drug possession with intent to deliver, Roussell was offered a chance to break his addiction through a groundbreaking new program. “I was very surprised to find out that I was able to have methadone in prison,” he says.
Every day while locked up, Roussell drank a 55-milligram dose of methadone, the medicine doctors have used for 50 years to help people get off heroin. “It was very comfortable, very helpful,” says Roussell, a sandy-haired man with deep blue eyes and a handlebar moustache. “I started feeling like my recovery was kicking in.”
Released from prison after three months, Roussell spent eight months in residential treatment. Now he’s living with his parents in Tiverton, his seaside hometown, and working as a landscaper and maintenance man in a business park. His case will be dismissed after his graduation from drug court this month. Every morning, on his way to work, he stops by an opioid treatment clinic for a daily methadone dose. “That keeps me stable,” says Roussell during an interview at Rhode Island’s government campus in Cranston. He’s gone a year without taking heroin. If not for his methadone regimen, he says, “there’d be a good chance of me using.”
Roussell got treatment for his addiction in prison because, two years ago, Rhode Island decided to do something no other state has done. In 2016, it began offering its prison inmates all three medications approved to treat opioid addiction: methadone, Suboxone, and Vivitrol . About 350 Rhode Island prisoners each month take one of the three medicines. Crucially, they continue their treatment after their release, usually through the state’s Medicaid program, when they’re at the greatest risk of a relapse and a fatal overdose. It’s among the opioid crisis reforms championed by Governor Gina Raimondo in response to Rhode Island’s overdose death rate, ninth-highest among the 50 states.
The $2 million program has already saved lives, state officials say. In the first half of 2016, 26 recently incarcerated people died of drug overdoses in Rhode Island. In the same period last year, only nine did. That’s 61 percent fewer fatalities.
“The magnitude of that drop in mortality is almost unheard of in public health,” says Dr. Josiah Rich, a professor at Brown University’s medical school and co-director of Rhode Island’s Center for Prisoner Health and Human Rights. It’s a small study based on overdose death records, not a randomized test controlled for other possible causes. Still, the results, published in the American Medical Association journal JAMA Psychiatry in February, suggested that the medication-assisted treatment program prevented one overdose death for every 11 inmates it treated.
Rhode Island’s approach is rare in the nation’s prison systems, most of which offer no medication-assisted treatment. Roughly 400,000 inmates nationwide might benefit from it: 20 percent of the nation’s 2.3 million inmates are incarcerated on drug offenses, and estimates of regular opioid use or addiction among inmates range from 17 percent a decade ago to 25 percent now. Some states offer inmates Vivitrol, an opioid blocker. But because methadone and Suboxone are also opioids, corrections officials usually ban them as contraband, concerned that inmates might divert to other inmates.
Doctors and public-health officials consider medically-assisted treatment the standard of care for opioid addiction. But it suffers from a widespread belief, even in parts of the recovery community, that it is simply “substituting one drug for another.” The Trump administration has given mixed signals on the issue. In May of last year, former Health Secretary Tom Price told a reporter, “If we just simply substitute buprenorphine or methadone or some other opioid-type medication for the opioid addiction, then we haven't moved the dial much.” Price later backtracked, saying he supported some MAT programs. Trump’s opioid policy, released in March, supports MAT for criminal offenders.
The distrust of medication-assisted treatment in prisons is starting to change, especially in New England, home to five of the 11 states with the highest fatal overdose rates. Vermont and Connecticut operate smaller medication-assisted treatment programs for some inmates, and on August 9, Massachusetts Governor Charlie Baker signed a bill that expands treatment in the state’s prisons. Advocates in Rhode Island say they hope their state’s approach becomes a model for the nation.
“We’re in the middle of a horrible epidemic,” says Rich. “There’s no reason this can’t be done just about anywhere else.”
***
When Gina Raimondo was running for Rhode Island governor in 2014, the opioid epidemic wasn’t a campaign issue. The candidates didn’t run on it, and it didn’t come up in their debate. But it did come up when she spoke to voters. “I would hear about it constantly, mostly from parents who’d lost kids,” she said in a recent interview.
Now, Rhode Island’s prison treatment program has emerged as the most innovative part of Raimondo’s anti-overdose strategy. It’s an accomplishment she’s talking about as she runs for re-election in November, in a state with a population of 1 million that’s seen more than 1,000 overdose deaths since 2015.
“We’re the only state in America that has a state-supported, state funded, full range of medically assisted treatment in the prisons,” Raimondo told a gathering of Rhode Island public health professionals at the Community Overdose Engagement Summit in Warwick, R.I., in June. “And it is working.”
Soon after she took office, Raimondo created an overdose prevention task force. Its expert advisers included public-health advocates and officials who had wanted to get a methadone program going in Rhode Island’s prison system for decades.
“It met with a lot of resistance over the years,” recalls Rich, a task force advisor, who wrote unsuccessful grant applications for a prison methadone program in Rhode Island 20 years ago. “People who have this disease are thought to be somewhat subhuman.”
Once, in the 1990s, Rich got into a disagreement with a prison nurse over whether to help an inmate suffering from drug withdrawal. “I said we should give him medication to make him feel better,” he recalls. “She said, ‘No, we don’t do that. He’s supposed to suffer. That way he won’t come back again.’”
“This is something I’ve wanted to do since I started here 20 years ago,” says Dr. Jennifer Clarke, the medical programs director for Rhode Island’s corrections department. “Once the task force was together, and saw corrections as a priority, we were already ready to come up with a plan.”
Clarke and the other advisers asked for a broad program that would offer medication-assisted treatment (MAT for short) to three types of inmates.
Inmates who come into the corrections system with a doctor’s prescription for MAT are no longer taken off it. Since the 1990s, Rhode Island prison medical staff had been giving methadone patients a week’s worth of the drug, then tapering them off it—a standard practice in corrections systems around the country, Clarke says. “I think that’s where we’re doing the greatest damage to communities, by taking people off of MAT,” she says.
New inmates who are withdrawing from opiates go straight into an induction program —a few days of methadone or Suboxone to ease withdrawal symptoms. “[We] start people on treatment right when they come in the door,” Clarke says. This part was simple to implement statewide, because Rhode Island has no county jails. The smallest state in the union, just 37 miles wide and 48 miles long, it has a combined prison-and-jail system in Cranston with a single medical staff.
Inmates with histories of addiction can choose to go on methadone, Suboxone or Vivitrol a few months before their release. “This was, I think, the most difficult for people to accept,” says Clarke, “that we were taking people who’d been off opiates for years and putting them back on MAT.” But just-released former inmates are at the highest risk of dying of an overdose. They’ve lost their physical tolerance for opioids, but they haven’t lost their cravings.
“It’s the same thing as smoking,” says Clarke. “[If] somebody’s here for five, 10 years, it doesn’t mean they’re not craving a cigarette the whole time. They haven’t actually quit. They’re not actually in recovery. They’re just away from the substance.”
The task force created a four-point plan: better prescription monitoring, more access to the overdose-reversing drug naloxone, more peer-recovery programs and more medication-assisted treatment, in prison and across the state.
The prison MAT program faced skepticism, but not vocal opposition, says Raimondo. Legislators pressed her to make the case for the $2 million program. Among the public, “There was a little pushback that these are people in prison, and why are we giving health care to prisoners?” says Raimondo. Prisoners are “much, much more likely to overdose and die when they come out,” she argued, “so, for this much money, we could save lives and save money.” The legislature included the funding in the state’s 2017 budget, with little to no opposition. Raimondo says the consensus reflects how the state has come together to deal with the opioid epidemic, which she calls Rhode Island’s biggest public-health crisis.
“We have a worse problem in Rhode Island than other states,” she says. “People realize that.”
***
For inmates with chronic pain and opioid addictions, methadone and Suboxone can offer a path out of vicious cycles.
Bill Fox, 53, has spent 26 years in Rhode Island’s prison system, for crimes ranging from felony domestic violence to forgery. He went on Suboxone three months before his release from prison this March. Now, he’s living at a sober house in Providence and receives Suboxone at a state-funded treatment center. He takes Suboxone three times a day, letting a small orange strip containing the drug dissolve under his tongue.
“It keeps me off any of the hard drug stuff,” Fox says. “It regulates my life in a roundabout way. It keeps me in check: Here’s something for your pain, and everything else falls into place.”
Fox says he first took an opioid painkiller at age 12, for fun, and first snorted heroin at 18 or 19. He says he used prescription opioids and then heroin after several injuries, including a three-story fall 20 years ago when he was capping a chimney and the staging gave out. Throughout a nearly hour-long interview, Fox rubs and presses his right knee to ease its ache.
“The painkillers, they ruined my life,” he says. He says he’d often con or bully people to get money for OxyContin or heroin. If not for Rhode Island’s MAT program, Fox says, “I’d be back in jail.”
Prisoners’ cravings for drugs will often get worse as their release date approaches, says Linda Hurley, president and CEO of CODAC Behavioral Healthcare, a state-funded nonprofit that administers the MAT program before and after prison.
“[They have] dreams about using substances, how it’s going to feel,” Hurley says. They catch themselves starting to plan for drug-seeking once they’re out. Afraid, they’ll turn to the MAT program for help. “They’re no longer physically dependent on the substance, but the brain hasn’t healed,” Hurley says. “They’re still addicted.” Without MAT, they’re extremely vulnerable to a fatal overdose. In the first half of 2016, 15 percent of the people who died of an overdose in Rhode Island—26 out of 179—had been in Rhode Island’s corrections system a year before. Ten died within a month of their release. “When they get out, they don’t have the same tolerance anymore, but the brain wants the same amount,” Healey says.
Other states with prison MAT programs, including West Virginia, Kentucky, and Massachusetts, offer only Vivitrol injections, just before inmates are released. But in Rhode Island, where inmates choose which medication they’ll go on, only about 1 percent choose Vivitrol. About 60 percent choose methadone, while 39 percent choose Suboxone.
Vivitrol blocks opioids from producing a high. But it doesn’t help with withdrawal symptoms, so it isn’t appropriate for newly incarcerated inmates. Unlike methadone and Suboxone, Vivitrol doesn’t relieve pain, and its users have to turn to non-opioid analgesics for pain relief.
“It’s a great medication if the patient wants it and if it addresses [their] symptoms,” says Clarke, the prison medical director. “Like so much else in medicine, the best medicine for an individual is one they’re going to stick with and take.”
Michael Manfredi chose Vivitrol in 2016 on a fellow inmate’s recommendation. He was finishing a four-year prison stint for robbery, assault and breaking and entering. “Every time I was incarcerated, it was due to my addiction,” says Manfredi, 55, who started shooting heroin at 15 and first went to prison, for robbery, at 18. “The previous couple of times that I went, they just sent you out with nothing, no maintenance,” he says.
“Vivitrol for me was a godsend,” says Manfredi. “I’ve lost the desire to use, lost the urges to use, the cravings.” He goes to a center in Providence every 28 days to get a Vivitrol injection in his hip and to meet with a team of counselors, including social worker and a psychiatrist. He also goes to several peer-help meetings a week. “I had to work the program,” he says. “Just getting my shot wasn’t good enough.”
Two years after Manfredi’s release, he works for a construction company and lives with his adult daughter. “My daughter finally can trust me again,” says Manfredi, who has a long, thin face and who shakes with emotion as he tells his story. “She can go out of the house and not worry I’m going to take anything and sell it.”
Vivitrol “changed my life,” Manfredi says. “I didn’t think I could be a normal person.”
***
Rhode Islanders say they hope other states use their prison program as a model for fighting addiction.
“Other governors have said, ‘Hey, that seems to be working, tell me about it,’” says Raimondo. At last year’s National Governors Association conference, she talked up the program while on a panel about the opioid epidemic. “After that, a lot of them came up to me and said, ‘We want to do that.’”
The program’s supporters have plenty of advice for other states. “You shouldn’t even think about doing a program like this in a correctional setting if you don’t connect with [inmates] after release,” says Rich, the doctor and prisoners’ health advocate.
Setting up a system to continue ex-inmates on treatment would be a bigger challenge in big states. “If somebody is released in Rhode Island, and they’re a Rhode Islander, they’re probably no more than 40 miles away,” says Clarke.
Corrections staff have to guard against prisoners diverting the medicine to other prisoners under threats or coercion. Methadone and Suboxone are mild opiates that usually don’t trigger a high at prescribed doses, says Rich, but they can be abused. “We worry people on treatment may be manipulated,” Clarke says. So the prison administers Suboxone in dissolvable strip form, because tablets, though cheaper, take longer to dissolve and are easier to divert. Prisoners on methadone are required to drink water and eat saltines after drinking their dose, so their fellow prisoners know they can’t spit up the medication later.
Suboxone is among the drugs commonly smuggled into prisons, often during prison visits. Prisons across the country have tightened their inspections of incoming mail to catch Suboxone secreted in letters and envelopes. In Ohio prisons, where five percent of inmates tested positive for drugs in 2016, Suboxone ran a close second to marijuana as the most popular contraband drug.
Rhode Island’s corrections department hasn’t yet sifted its contraband records to try to measure potential diversion, but Clarke says one warden has told her the amount of contraband Suboxone coming into the prisons may be dropping, “because people are being treated.”
Outside Rhode Island, acceptance of medication-assisted treatment for inmates is slowly growing. New York City has had a methadone program at its Rikers Island jail complex since 1987, though inmates likely to be sent to state prison aren’t eligible for maintenance therapy. Philadelphia jails have a methadone program too. Vermont has a MAT program for prison inmates who were on methadone or Suboxone before their arrests, as do two Connecticut jails. Massachusetts will do the same next year. On August 9, Governor Baker signed a bill that will create a similar program for existing MAT patients in several state prisons.
Trump’s opioid initiative, announced in March, pledges to screen all federal inmates for opioid addiction when they enter prison, and facilitate Vivitrol treatment if they’re released to residential community centers. It also called for increased federal support for state and local drug courts to provide evidence-based treatment to addicted offenders.
Raimondo – who faces a tough re-election race in November -- says the Trump Administration isn’t doing enough. “Like so much of what they do, they don’t have any serious policy,” she says. “If the president were really serious about this, there would be federal funding behind it.
“Our medically-assisted treatment program—that could easily be federally funded,” Raimondo says. “It could be done in 50 states tomorrow. For a small investment, we could save thousands, tens of thousands of lives.”
Erick Trickey is a writer in Boston.
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https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html
Opioid Users Are Filling Jails.
Why Don’t Jails Treat Them?
Getting methadone in jail gave a Connecticut
heroin user a firmer foothold in recovery. But
fewer than 1 percent of jails and prisons allow it.
By TIMOTHY WILLIAMS AUG. 4, 2017
NEW HAVEN — When Dave Mason left jail in October 2015 after his 14th criminal conviction, the odds were good that he would soon end up dead.
A man with a longtime heroin addiction, Mr. Mason was entering one of the deadliest windows for jailed users returning to the streets: the first two weeks after release, when they often make the mistake of returning to a dose their body can no longer handle.
Standing outside the New Haven Correctional Center, clutching his few belongings in a brown paper bag, Mr. Mason appeared precariously close to taking that path. His ride never showed up. He had no money, no contact with his family and nowhere to live.
But instead of panhandling for cash to score drugs, he went to a methadone clinic, determined to stay clean.
Methadone was not a new thing for Mr. Mason, 43. He had been on it before he went to jail for cashing forged checks. But it is almost always banned in jail, increasing the chances of relapse. Of the nation’s 5,100 jails and prisons, fewer than 30, according to the federal Bureau of Justice Assistance, offer opioid users the most proven method of recovery: administering methadone or buprenorphine.
Mr. Mason, though, had been allowed to take his daily dose, in a fledgling program that helped him continue what he says has been his longest period off heroin since his teens.
“It is the key to my success,” he said. “It did what it was supposed to do. It kept me clean.”
For more than a year, the PBS series “Frontline” and The New York Times followed 10 newly released prisoners in Connecticut, including Mr. Mason, as they tried to start over. Though the stories were about the criminal justice system, they were also, inevitably, about addiction — three out of four inmates in Connecticut have a drug or alcohol problem, according to the Department of Correction, and the number who use opioids has soared.
For these 10, there were many setbacks, and what counted as success was modest. Mr. Mason met up with his girlfriend, Dani Herget, who at the time also used heroin; slept outdoors; panhandled for money; and used a wide variety of street drugs. Twice he was ordered into treatment, and once he was sent back to jail. Ultimately, he reunited with Ms. Herget, 21.
But despite his self-destructive tendencies, he says he stayed off heroin and has ultimately been able to moderate his use of other drugs.
Though limited in size, the methadone treatment program is one of numerous changes Connecticut has made to help inmates successfully re-enter society. But for most jails and prisons, such programs are out of the question. Much of the criminal justice system still takes a punitive approach to addiction. Many who work in corrections believe, incorrectly, that treatments like methadone, itself an opioid, allow inmates to get high and simply replace one addiction with another. And many officials say they have neither the money nor the mandate to provide the medications.
“The best way to not get addicted to opioids is to never use them,” said James M. Cummings, sheriff of Barnstable County in Massachusetts, who opposes methadone in jails despite a sharp rise in addiction and overdoses there.
But maintenance treatments like methadone, if uninterrupted, are proven to reduce arrests and increase employment, and for many with addiction are the only thing that works. In July, a White House commission on opioid addiction called for increasing inmates’ access to addiction medication.
Dr. Kathleen Maurer, director of health services for Connecticut’s corrections department, said it was critical for jails and prisons to treat opioid addictions like chronic diseases, including providing medicine.
“We don’t take away people’s insulin or their asthma inhalers,” she said. “Why should we take away their methadone?”
In the New Haven jail, 35 inmates stand in line every day at 12:30 p.m. to drink the contents of a plastic cup containing a green, bitter fluid, followed by a swallow of a sweet orange drink to wash it down. A corrections officer shines a flashlight beam into their mouths as they leave the room to ensure that they have nothing hidden there.
With this dose of methadone, individually calibrated to alleviate cravings without producing a high, these inmates have been spared the torment of detox — a painful process that includes diarrhea, insomnia, severe cramping and hallucinations. But more important, they have less danger of relapse.
Methadone and Suboxone, a combination of buprenorphine and naloxone, work by reducing cravings and preventing withdrawal symptoms. Because they activate opioid receptors in the brain, both drugs can cause a high in large enough doses. Suboxone is already commonly smuggled into lockups, whether to get inmates high or help them avoid withdrawal.
Though people do not die from opioid withdrawal, without proper care they can die from related effects like dehydration. There have been several such deaths, as well as dozens of overdose deaths, in jails in recent years.
Few studies have measured the outcomes of jail-based methadone treatment. But a 2001 study at Rikers Island, which started one of the country’s first jail-based methadone programs in 1987, found that participants were less likely to commit new crimes and more likely to continue treatment. And a 2014 Australian study found fewer overdose deaths after release.
In New Haven, Mr. Mason, who started injecting heroin at age 17, represents an unexpected success, officials say, given the length and severity of his addiction.
Tall and lean with missing front teeth and a limp, Mr. Mason avoids giving detailed answers to questions about his life and frequently contradicts himself. He is chronically homeless and has become an expert in surviving on the street, subsisting for years by panhandling and theft. He knows where to go for free meals and where on the street to buy benzodiazepines to combat his anxiety. He has committed to memory the schedules of certain police officers who will arrest him at the slightest provocation.
He has been in jail more times than he remembers — for credit card theft, shoplifting and multiple probation violations, among other charges.
But he said being able to continue using methadone while in jail had helped convince him that it was time to try to change.
“Everybody has to hit a turning point where you can’t picture your life with or without drugs,” he said. “You’re at this spot. You know you can’t use anymore, but you don’t know how not to use anymore.”
Connecticut jails were not even allowed to dispense methadone in 2013, when Dr. Maurer, the prison medical director, saw a report that drug overdose deaths in the state had more than doubled over the previous six years. Forty percent of the victims were former inmates.
Dr. Maurer spent months helping persuade state lawmakers to change the law. Then she had to convince the warden.
Like many jail officials, Jose A. Feliciano Jr., the New Haven jail warden, was skeptical. “I thought, ‘That’s another substitute for heroin,’” he said.
Jose A. Feliciano Jr., the warden of the New Haven jail: “I can tell you the climate around these people is better than it had been before,” he says of the prison’s heroin-addicted inmates after the methadone program’s start.
But even he had been personally touched by the problem: Two of his relatives had been heroin addicts who died of AIDS. And one of his three children is recovering from addiction.
“To say that’s something that didn’t influence me would be a lie,” he said. “Not until it impacts people close to you do you understand. It’s incredible how quickly it can overtake a person.”
Initially, Mr. Feliciano opposed the disruption that methadone handouts would surely cause. “But the more I talked to Dr. Maurer, the better I understood that it is an opportunity to let them live a clean life,” he said. “These individuals at some point in time are going to leave these walls. When people run out of drugs, they’re going to start stealing, committing crime.”
Officials say the treatment has shown promise in reducing fatalities and making inmates more likely to continue treatment once they are released, and Mr. Feliciano said the behavior of addicted inmates improved.
“I can tell you the climate around these people is better than it had been before,” Mr. Feliciano said.
But attitudes have not completely shifted, and methadone is still viewed as a privilege. Inmates can be kicked out of the program for any disciplinary infraction.
Karen Martucci, a spokeswoman for the Department of Correction, said the state had a responsibility to maintain order and enforce rules. “It’s also important to recognize that methadone has a contraband value in a correctional environment,” she said.
When Mr. Mason landed back in jail on a probation violation, he got in a fight and was rejected by the program, forcing him into methadone withdrawal, considered far more agonizing than heroin withdrawal.
“It should be illegal,” he said. “They shouldn’t be able to put a dude through that.”
Severe budget shortfalls have limited the program to just two of the state’s 15 jails. It is open only to those who were already taking methadone when they were arrested.
And unlike Rhode Island and Vermont, which offer methadone and Suboxone, Connecticut offers only one option, which may not work for everyone.
A growing number of jails, especially in rural areas, have opted to treat inmates not while they are in jail, but on the way out, giving them a one-time shot of a newer medication, Vivitrol, as they are released. Vivitrol, which unlike methadone and Suboxone is not a narcotic and has no street value, blocks opioid receptors in the brain, making getting high nearly impossible. It is far more expensive, and far less proven, than methadone and Suboxone, but its manufacturer often gives it to jails free. Its effect lasts about a month.
Even in Connecticut, inmates say, prejudices against methadone persist.
“The D.O.C. hates the methadone program,” a friend and jailmate of Mr. Mason’s said when they met on the street and compared notes. “They make fun of us and stuff. They’re like, ‘Oh, you junkies, go get your juice.’ Then they put all our names on the board so everybody in the dorm knows who’s on methadone.”
But for the first time in years, Mr. Mason has allowed himself to envision a future free of heroin — and along with it, the hustles and thefts necessary to support an addiction.
After his release — and over a period of several months — Mr. Mason painstakingly reduced his methadone intake to the point that he has been able to switch to the less powerful buprenorphine. The new medication, he said, allows him to think more clearly.
He has never held a steady job, and his days are often spent watching hours of television with Ms. Herget. He takes medication for severe anxiety and other mental health problems.
But he has begun to talk of finding work, saying he would like to become a drug counselor.
Sometimes, he expresses reservations about a relationship with another recovering addict.
Mr. Mason goes to rehab, but must leave Ms. Herget behind.
“I just don’t want to be with a wife who shoots dope,” he said. “I’m a heroin addict. It’ll take like that for me to fall in love with it again. And then, nothing else matters.”
But Ms. Herget’s pull on him is strong, and at other times, he speaks of marriage.
“I’m excited to live a decent life, be the man Dani needs and deserves,” he said. “I’m grateful to be there for my girlfriend. I can spare her 20 years of living hell.”
Matthew O’Neill and Jeff Arak contributed reporting from Connecticut and New York City.
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https://www.nytimes.com/2018/09/17/opinion/drugs-dea-defund-heroin.html
The Drug Enforcement Administration has proved itself incompetent for decades.
By Leo Beletsky and Jeremiah Goulka
Professor Beletsky is the faculty director of Northeastern University’s Health in Justice Action Lab, where Jeremiah Goulka is a senior fellow.
Sept. 17, 2018
[excerpt here below]
We urgently need to rethink how our nation regulates drugs. What should our goals be? How can we design institutions and performance metrics to achieve them?
The answers lie at the local and state levels. In Rhode Island, opioid overdoses are declining because people behind bars have access to effective treatment. Massachusetts has deployed drop-in centers offering treatment, naloxone and other services. San Francisco and Seattle are planning to open safe consumption spaces which show tremendous promise as a tool to reduce overdose deaths and other drug-related harm. But the D.E.A. and its institutional parent, the Justice Department, stand in the way of some of these experiments.
We ought to reinvent the Drug Enforcement Administration.
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[recall below sent out to last fall-- still very much pertinent re: Matt Herring & us all!]
Fact: as of Oct. 25, 2017 (and this has been true just about every time I've researched this over past few years) there were 33 nonviolent drug addicts (not charged with any aggressive/violent act or drug-dealing/selling-- 25 of whom not even sentenced yet) locked up behind bars in the Dutchess County Jail-- at a cost of $125 per day to local taxpayers no less-- Jonathan (587 days), Alaric (259 days), Savon (120 days), Douglas (171 days), Spencer (160 days), Sarah (149 days), Maurice (136 days), Romairo (150 days), Elijah (125 days), Jaroslaw (58 days), Carl (64 days), Nicole (89 days), Michael (68 days), Eric (64 days), Leta (35 days), Rodney (48 days), Thomas (38 days), Timothy (34 days), Randy (28 days), Shaonna (28 days), Brett (27 days), Zachary (27 days), Manoj (24 days), James (20 days), Bleron (14 days), Curtis (12 days), William (11 days), Rahmel (6 days), Kaitlin (1 day), Halley (1 day), and Julian (1 day)-- a total of 2552 days of incarceration for those 33 nonviolent drug addicts over the last 587 days-- at a cost of $125 per day equals $319,000 spent-- despite rhetoric we've been hearing for years from Molinaro/GOP re: Crisis Stabilization Center about diverting nonviolent drug addicts from incarceration locally...not outraged?....sorry peeps you're not payin' attention-- email all 25 of us at countylegislators@dutchessny.gov-- and pls help get these facts into local papers by writing letters to the editor! (unless you like incarcerating drug addicts); recall how at big forum on this in 2016 mantra repeated over and over again in front of hundreds @ Family Partnership Center was this-- "addiction is a disease not a crime".....(so why is it that there are dozens of nonviolent addicts in our jail?):
http://www.poughkeepsiejournal.com/story/news/local/2016/09/11/heroin-opiates-addiction-faces-of-loss/89540472/ (needed: YOU to speak truth to power on this!)]
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https://www.nytimes.com/2017/06/26/opinion/jail-isnt-the-place-to-treat-drug-addiction.html
Jail Isn't the Place to Treat Drug Addiction
New York Times JUNE 26, 2017
To the Editor:
In "A New Kind of Jail for the Opiate Age" (Sunday Review, June 18),
Sam Quinones argues for in-jail treatment as a solution to rising opioid use.
We should certainly improve treatment in jails. But by focusing on
building drug treatment infrastructure inside the criminal justice system,
we further institutionalize its placement there. This reinforces the belief
that people battling addiction deserve punishment - undoing years of progress to understand addiction as a health issue.
Any contact with our justice system affects people beyond their time behind
bars. Incarceration or a criminal conviction should not be a prerequisite to
treatment. In many states, possession of opioids remains a felony. We should
divert these people away from incarceration and into treatment programs instead.
Jails and prisons have a notoriously bad track record of providing health
services. They are built to punish and isolate, not rehabilitate. The quality
and availability of treatment in them vary greatly. In responding to addiction,
we should not mistake a short-term solution for an indispensable one.
INIMAI CHETTIAR, GRAINNE DUNNE
NEW YORK
The writers are, respectively, director of the Justice Program at the Brennan
Center for Justice at the N.Y.U. School of Law and a research associate in the program.
https://www.brennancenter.org/publication/how-many-americans-are-unnecessarily-incarcerated
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To the Editor:
Using jail as a program for drug users is a symptom of another urgent problem: mass incarceration, which increasingly takes the form of an overcrowded rural or small county jail.
In 2010, Kenton County, Ky., built a very large jail for a county its size,
equivalent to New York City's tripling the size of Rikers Island to 30,000 beds.
Kenton's new jail is overcrowded, costs the county more than expected, and is soaking up tax dollars that could be used for innovative, community-based
drug treatment that would look much more affordable if the jail weren't so large.
When you have a hammer, everything looks like a nail. But there is another option: Downsize the jail and invest in community-based treatment so that the criminal justice system does not become the de facto public health strategy in rural places.
JACOB KANG-BROWN, NEW YORK
The writer is a senior research associate at the Vera Institute of Justice.
http://www.safetyandjusticechallenge.org/wp-content/uploads/2015/01/incarcerations-front-door-report.pdf
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https://www.aclu.org/blog/mass-incarceration/jail-doesnt-help-addicts-lets-stop-sending-them-there
Jail Doesn't Help Addicts. Let's Stop Sending Them There.
By Kara Dansky, Senior Counsel, ACLU Center for Justice
OCTOBER 17, 2014 | 11:17 AM
Misti Barrickman has scoliosis. Since she was a teenager, it's been debilitating. It hurt to lie down. It hurt to stand up.
She started taking Oxycontin to help with the pain and became addicted. She came to Seattle to find large quantities of the drug. Unable to find it and feeling increasingly desperate, Misti tried what was readily available: heroin. For the next seven years, she struggled with addiction. She lived between a tent and a jail cell, racking up charges for possession and prostitution.
Almost 30,000 people were arrested for drugs in New York in 2012. Over 117,000 people were arrested for drugs in California in the same year. Nearly 10,700 people were arrested for drugs in Washington that year.
Some of these people, like Misti, have been arrested multiple times - their addictions haven't been helped by stint after stint behind bars. Too often, the cycle just keeps repeating itself.
Seattle is trying something different.
Since 2012, the city's Law Enforcement Assisted Diversion program (LEAD) cuts out the criminal justice middleman. Instead of jailing people struggling with addiction, officers connect people directly with the treatment and services that can actually help them get sober.
Instead of wasting time and money with a court hearing and saddling people with a criminal record before they can access treatment and services, LEAD doesn't waste time. And unlike drug courts, LEAD participants who relapse are not threatened with jail time and expulsion from the program.
For the people we interviewed, the program is working. Misti's been sober now for two years. She no longer lives in a tent, and her pain is under control. She is in school. The latest video in our "OverCriminalized" series - produced in partnership with Brave New Films and The Nation - tells Misti's story and the story of others whose lives have improved after police took them to services, not to jail.
For decades, this country has been waging a failed war on drugs. Drug use hasn't gone down. Drugs are just as available as they used to be. Instead of solving our drug problem, we've become a society that seemingly disregards millions of lives - particularly the lives of black and brown people.
Although the majority of people who use and deliver drugs in Seattle are white, the black drug arrest rate was 13 times higher than the white drug arrest rate in 2006. Aggressive over-policing has ravaged communities. Large swaths of the population have been locked up. And billions of dollars have been wasted that could have been much better spent on interventions that could have actually changed the course of people's lives.
Drug addiction has become one of the many social problems that we've relegated to the criminal justice system. But as with homelessness and mental illness, handcuffs and jail cells haven't made things better and have cost much more than the treatment and services that can. It doesn't have to be this way. America can safely reduce our reliance on incarceration. Several states have reduced their prison populations while crime rates have dropped.
Addiction should not be a crime.
"OverCriminalized," a new series produced Brave New Films in partnership with the ACLU and The Nation, profiles three promising and less expensive interventions that may actually change the course of people's lives. It's time to roll back mass criminalization and focus on what works.
[note: not just Seattle-- Albany has LEAD program too; we need LEAD here(!):
http://www.timesunion.com/local/article/Albany-launches-LEAD-diversion-program-7219908.php ;
https://www.seattletimes.com/seattle-news/crime/lead-program-for-low-level-drug-criminals-expands-to-east-precinct/ ]
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