Tag: physiology

BOSTON — Money is flowing into state and county correctional facilities to help treat substance abuse disorders, putting sheriffs and jail wardens on the front lines of the state’s battle against opioid addiction.

A first-of-its-kind report on funding for the 14 sheriffs offices across the state shows that a sizable chunk of more than $23.5 million in state and federal grants they received last year was earmarked for jail-based, medication-assisted treatment programs.

The Essex County Sheriff’s Office received more than $2.7 million in federal and state grants for programs in the previous fiscal year, much of which was devoted to medication-assisted treatment and other substance abuse programs.

The money was provided through grants from the U.S. Department of Justice and the state Department of Public Health, among other funding sources.

Essex County Sheriff Kevin Coppinger said about two-thirds of the inmate population is struggling with some kind of substance use disorder, and the demand for drug treatment is increasing.

He has an average of about 170 inmates on medication-assisted treatment and other programs at Middleton Jail and other locations.

The efforts are crucial to prepare inmates for reentry into the community and reduce recidivism by breaking the cycle of incarceration, he said.

“When people get released we don’t want them to end up back in the criminal justice system,” Coppinger said. “We want to get them out of here and keep them on the straight and narrow.”

Essex County was one of the first in the state to set up a detox inside the jail, and has expanded its substance abuse treatments over the years. It has been approved for a license to administer medication-assisted treatments.

In some cases, inmates request medication-assisted treatment to get clean while they are incarcerated. In others, people committed to the jail are already in a community-based program receiving medication and are able to continue their treatment while they do their time, Coppinger said.

He said the Sheriff’s Office is building a new dispensary for opioid-related drug treatments at its prerelease center in Lawrence – known as the “farm” – which also will have the authority dispense treatments without transporting inmates to an outside facility.

“Because we have a license, we can do this now, which is going to help us substantially,” he said. “Securitywise, it’s a no-brainer. We can dispense it in-house now.”

Sheriffs see spike in need

In Middlesex County, the Sheriff’s Office received more than $815,000 in grants in the previous fiscal year with the majority of the money devoted to opioid and other substance abuse programs, according to the report.

The Barnstable County Sheriff’s Office received more than $3.7 million in the previous fiscal year, with more than $520,000 devoted for medication-assisted treatment and reentry services, the report noted.

The Plymouth County Sheriff’s Office reported a nearly $900,000 grant from the Department of Public Health for medication-assisted treatment programs.

Sheriffs say while the inmate population in state and county correctional facilities has been declining for years, the demand for substance use and mental health treatment in county jails has been spiking, putting a strain on resources. The grants are intended to offset those costs, but more funding is needed, sheriffs said.

“It’s never enough money,” Coppinger said. “But I think it’s working based on feedback I’ve received from former inmates and the community.”

Treatment drugs, costs

There are three types of medication-assisted treatment in use in state prisons and county jails around the state, to varying degrees.

Methadone, which is usually dispensed to addicts who visit clinics for a daily dose, has been used for decades to treat heroin addiction. Until recently, it was one of the only options for medication-assisted therapy. Methadone, which acts to block opioid receptors in the brain, can ease withdrawal symptoms that may trigger a relapse.

Buprenorphine, which is sold by its brand name Suboxone and typically prescribed by a doctor, has become a preferred treatment.

There’s also naltrexone, a non-narcotic drug often known by its brand name Vivitrol, which is injected monthly.

None of the drug treatments come cheap. While methadone treatments can cost up to $3,500 a year per patient, even the generic form of Suboxone costs two to three times as much, according to the National Association of State Alcohol and Drug Abuse Directors. Vivitrol costs about $1,300 per shot, according to the group.

Opioid-related overdoses killed 2,357 people in Massachusetts last year, setting a new record high fatality rate of 33.5 per 100,000 people – an increase of 2.5% from the previous year, according to public health data.