The Hampden County (Massachusetts) Sheriff is helping men and women with opioid use disorder (OUD) receive treatment at CODAC Behavioral Health Care, the largest outpatient OUD treatment provider in Rhode Island. Through the Sheriff’s Medication Assisted Treatment (MAT) program, CODAC is providing methadone, buprenorphine, and naltrexone – the three medications approved by the Food and Drug Administration to treat OUD, to hundreds of patients.
In Massachusetts, OUDs have spiked during the pandemic. The problem is particularly difficult for jails, especially when current OUD patients are arrested and suddenly lose access to their medications.
“The MAT program helps people coming into our custody maintain these critical prescriptions without a fear of having to unnecessarily go through withdrawal,” Hampden County Sheriff Nick Cocchi said when the program was announced in March. “At the same time, it helps current inmates and substance use disorder clients maintain abstinence from illicit drugs and ensures they return to the community with the best chances of avoiding an overdose and transitioning into long-term recovery. Offering this program and these medications is the humane and right thing to do if we truly want to help people battling addiction-related issues.”
More than 80% of incarcerated individuals have some level of substance use disorder. When the problem is opioids, and people stop using drugs while incarcerated, their risk of overdose skyrockets upon release, partly because they don’t know they can’t go back to their former level of use due to their tolerance decreasing. The opioid-related overdose death rate upon release is 120 times higher among this population than among the rest of the adult population.
The Sheriff’s MAT program began in September, 2109, and as of March 2021 provided a bridge to treatment for more than 1,400 men and women in the Hampden County jail’s custody.
“We are proud to be working with the Hampden County Sheriff’s Department on this important initiative that helps move the needle forward in treating all those struggling with addiction as patients, just like those facing diabetes or cancer, and offer them the most comprehensive, evidence-based therapeutic approaches available, such as MAT,” said CODAC CEO Linda Hurley. “The progress we are making in Hampden County underscores that the program we pioneered in Rhode Island is both scalable and feasible elsewhere, and we are always available to help patients in other states.”
CODAC’s opioid treatment program, which is embedded at the sheriff’s department, is based on its nationally praised MAT program with Rhode Island Department of Corrections. People coming into the Hampden County sheriff’s department’s custody with an active prescription for MAT are allowed to continue their treatment regimen. In addition, anyone in custody who could benefit from one of the three medications – methadone, buprenorphine, or naltrexone (which also treats alcohol use disorder) – is assessed for treatment eligibility and started on it when appropriate.
CODAC provides more than medication to the inmates. Individual and group therapy are also provided. And for many of these individuals, this therapy is the first time they have ever had any therapy for substance use disorder. This therapy, according to CODAC, can help them carry over their recovery when they are released, and at a minimum decrease their chances of a fatal overdose.
Upon release from the jail, the Hampden County Sheriff’s Office connects them with a health care provider in their community, according to CODAC. As for people who are on MAT, they are connected directly to a licensed MAT clinic where they live.
One of the challenges of the pandemic was the lack of community-based treatment options, leaving MAT a critical lifeline for people leaving incarceration. After a court ruling last year stated that more people should be released, planning for treatment became difficult, according to staff. But the MAT staff adapted by treating any court appearance like a potential release date, coordinating community services at that time.
Missing even one day of medication can be very difficult for patients, so continuity of care when incarcerated is essential.
For more about CODAC and its work with the Rhode Island Department of Corrections, see https://atforum.com/2018/04/mat-during-incarceration-reduces-overdose-deaths/