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Nationally, about 80 percent of people in jail abuse alcohol or drugs. About half are considered clinically addicted. Oftentimes, substance use plays a direct or indirect role in a person’s jail time–which is why access to treatment is so important for both helping an individual recover, as well as reducing their risk for committing a crime.
Medication-assisted treatment, commonly referred to as MAT, is the use of a medication, usually in combination with counseling and behavioral therapy, to treat substance use disorders such as opioid addiction by normalizing the body’s brain chemistry and response to opiates.
Clinical research shows that MAT significantly reduces the need for inpatient detoxification services that are costly and typically have long waitlists. Hence, it is a quick, effective way to help individuals struggling with substance use disorder while in jail.
Research also shows a number of positive patient outcomes associated with MAT–including a decreased likelihood to use illegal drugs or commit other criminal activities.Therefore, MAT is a practical tool to reduce recidivism (the likelihood of returning to jail) and improve public safety.
At the Washtenaw County Jail, several forms of MAT have been used to help inmates experiencing opioid addiction. These include naltrexone (a medication used to help individuals with opioid dependence while in jail) and naloxone kits (medication that can quickly stop an opioid overdose, given to individuals upon release).
The jail has seen success with both of these medications–both for reducing recidivism rates, as well as decreasing the number of overdoses after release. To build on this progress, the jail has chosen to offer additional MAT options that were previously unavailable.
This January, the jail began to administer both methadone and buprenorphine–other medications used to combat opioid use disorder by reducing cravings and blocking the negative effects of opiates. Historically, many correctional facilities have not offered these expanded types of MAT because they are considered controlled substances. However, as Renee Casey, director of community corrections, explains, it’s important for the public to understand the numerous positive outcomes associated with the use of these medications.
“Many studies have shown great success with this route of treatment for high-risk opiate users,” says Casey. “However, it doesn’t mean that people will have to stay on the medication long-term.”
Casey says it’s important to have a wide range of options because treatment can look different for everyone and when people become incarcerated, they often lose access to medications that can help with addiction recovery.
“A primary goal of this program is for people to be able to continue their medications and treatment while incarcerated,” explains Casey. “From a physical and mental health standpoint, we know continuity of care is critically important for successful recovery.”
The jail is working closely with a local provider agency that is delivering the expanded services. The program is anticipated to serve between 10 to 20 high-risk individuals at any given time.
The expansion was made possible by a funding commitment from the Michigan Opioid Partnership (MOP), a statewide public-private collaboration that works to decrease opioid-related overdoses and deaths.
The jail also worked closely with community partners to design and implement the program, including with the Community Mental Health Partnership of Southeast Michigan (CMHPSM) and the millage team at Washtenaw County Community Mental Health (WCCMH).
“WCCMH really helped us make connections to the right community partners to have these initial conversations,” says Casey. “The project has been a year in the making.”