Hamilton County and its jail sit it in the Ohio River Valley, one of the hardest-hit parts of the country by the ongoing opioid crisis. The jail is packed with prisoners in for opioid-related crimes and while they’re forced to leave their addiction at the door, most pick it up right then they get out. Drug dealers known as the dope boys stationed outside the jail wait to get users right back on the powerful drugs. “In here, it’s black and white,” said Ashley Pels, a Hamilton County jail inmate. “When you get released it’s like ‘The Wizard of Oz.'”
According to the Cincinnati Enquirer, three out of four addicted prisoners let out of Hamilton County will return to their habit and the crime that comes with it. Now Hamilton County and Ohio public health officials are using FDA-approved drugs to help break the cycle and wean inmates from their addiction.
At Hamilton County Jail 52 inmates now take buprenorphine, one of a few FDA-approved drugs meant to weaken cravings and keep users off opioids. Though the corrections system has been slow in utilizing new therapies and drugs to break the addiction cycle, addiction experts and health providers like NaphCare are seeking to get help into more corrections systems. “Addiction is a disease. Even if an individual does not have access to substances during incarceration, the disease remains if it is not treated,” said Lindsey Vuolo, director of health and law policy for the Center on Addiction.
According to Jon Berg, a public health advisor with the U.S. Substance Abuse And Mental Health administration, 75% of people jailed for substance-abuse related crimes relapsed, but only 1 in 20 correction facilities across the country offers medication-assisted addiction treatment and only 1 in 200 offer buprenorphine that contains naloxone. More popularly known by its brand name Suboxone, the drug combination is a favorite of treatment centers due to its effectiveness.
Ohio criminal justice officials have long been against Suboxone, seeing it as a low-level opioid, but medical experts point out that’s not the case. If taken correctly the drug produces no euphoria but does help limit the stress and damage from opioid withdrawals.
Albany, New York Sheriff Craig Apple didn’t believe in drug-assisted treatment for inmates either but after talking to a few experts he implemented a Sheriff’s Addiction Program Recovery in Albany. The program provides naltrexone to inmates, utilizes drug counseling, and transports addicted inmates directly from jail to a treatment center after their sentence. Apple saw fewer inmates returning right away. In 2018 the Albany program expanded to include all FDA-approved opioid medication. Instead of 75 percent of drug offense related inmates returning, Albany now sees recidivism rates between 12 and 20 percent.
Corrections healthcare platform NaphCare has been at the center of most drug-assisted treatment programs in the U.S. The Birmingham, Alabama-based company is currently working on or has already set up 20 such programs across the country from Washington to New Jersey.
NaphCare sends trained staff across the country to help educate corrections staff and even covered the cost of training as part of its $7.5 million contract with Hamilton County jail. NaphCare also works with the Talbert House, a counseling organization for Hamilton county’s female inmates to continue medication and other counseling services after inmates leave jail. Previously inmates were only given medication to help avoid serious withdrawal, but as of last year, the medication is now part of a daily treatment regimen at Hamilton.
Brad McLane, NaphCare’s chief administrator, has been a prominent figure in getting medication assistance for addicted inmates. “If you’re in a program where you’re taking buprenorphine or methadone and it’s keeping you off drugs, we want to continue that,” he said. McLane has also convinced the Ohio Medical Board to shelf current rules regarding drug assistance in jails and emergency departments to get the life-saving medication into more hands.
Pels has experienced the benefits of drug-assisted therapy firsthand. “It helps clear that fog. Makes it to where you don’t focus so much on the cravings and getting high,” Pels said. “I was able to focus when I went to my meetings, when I went to group therapy or one-on-ones. I was able to focus on my recovery.”
Elen Augspurger, project director of Ohio’s opioid response program, said more Ohio corrections institutes will take up drug-assisted treatment in the coming months. Butler County recently added the buprenorphine option for pregnant women while other institutions have dipped their toes in the water with medication injections before starting daily pill programs.
Though the treatment programs are in their early stages and adoption is slow, support from criminal justice officials is gaining support. Hamilton County Sheriff Jim Neil supports the recent actions and NaphCare. “The county jail is ground zero for opiates and synthetics,” Neil said, “because this addicted culture finds its way to the county jail through their behavior. It’s something else controlling them and what they do.”
The strong education and benefits of the program have Pels both excited and nervous to be released back onto the streets that have caused her so many issues. Pels plans to be immediately picked up by a mentor on her release and driven to a medical provider for a dose of naltrexone. Other inmates like Samantha Thomas have similar plans to avoid the temptation. “I don’t know sober people outside of jail,” she said. “I am from downtown. So this is where I get high. So walking out this door, yeah, I’m automatically in the devil’s playground.”