The medication-assisted treatment (MAT) program loops in local post-release behavioral therapy for inmates battling addictions during their incarceration.
By Matt Skoufalos | February 27, 2019
In 2018, the Camden County Jail became one of just 20 correctional facilities across the country to offer its inmates access to maintenance medications like Vivitrol, Suboxone, Methadone, and Narcan, all of which are used to counteract the effects of opioid addiction.
Now the facility is seeking to expand the program to serve a broader base of its population, the better to address their health needs while in jail, and prevent relapse upon release.
“Sixty-five percent of the national prison population suffers from addiction,” said Camden County Freeholder Jonathan Young, liaison to the county Department of Corrections, at a press conference Tuesday.
“After leaving prison, their relapse is probable,” Young said, citing the “high crime and poverty rates” in the area immediately around the prison, as well as the active drug trade in Camden City.
“We want to make sure our inmates are better when they leave than when they came in,” he said.
Established with a $200,000 grant from the state Department of Corrections, the medication assisted treatment (MAT) program provides inmates with access to opioid-interference medication as well as behavioral therapy after they’re released.
Since the program was begun last year, more than 100 inmates have participated in it voluntarily.
Forty-six of them have received one Vivitrol shot while incarcerated, and another upon release; six or seven of those have participated in follow-up care provided by Camden Project H.O.P.E. and the Volunteers of America Safe Return program.
“These individuals are our neighbors, fathers, sons, mothers, daughters,” said Camden County Jail Warden Karen Taylor.
“They are our community. We can do better.”
New Jersey correctional facilities saw more than 300 addictions-related deaths in 2018, and another 329 in 2017 that are suspected to have been drug-related, Taylor said.
“Numbers fail to represent the reality that these people live in our communities and are struggling to receive treatment,” she said. “Our goal is to reduce overdose deaths, diminish relapses, reduce recidivism, and help men and women re-enter the community.”
The variety of medications used, and the provision of follow-up behavioral therapy as a supplement to pharmaceutical treatment, reflects best practices in treating people suffering from addiction, Taylor said.
“We understand more than ever that we must treat the whole patient, not just the addiction,” the warden said.
Taylor’s predecessor, Camden County Director of Corrections David Owens, said the policy shift around caring for inmates with addiction is “mind-boggling beyond our expectations.”
“There was a time where, if someone came into our facility and was addicted to narcotics, our treatment for them was very, very low,” Owens said.
“We would try to make them comfortable during the detoxification process, but there was a lot of pain,” he said. “The things we’re doing today, we could only dream about.”
Owens couched the MAT program in the historical context of broader criminal justice reform, which he said has helped lower the inmate population as well as shifting thinking around its custodial needs.
“We basically stopped at the front door,” Owens said. “Individuals would come into our care, be discharged, and go out the door.
“The great thing about this program is the partnership with the community,” he said. “After they leave us, they can go and continue their care.”
Owens estimated that 60 percent of the 750- to 800-inmate population at the county jail is “drug-addicted or drug-involved,” and another 17 percent is “outright commitable for mental health.”
“The innovativeness of our program, the humane treatment, has brought us to where we are,” Owens said.
“It’s the people in the [health] profession, with their tremendous strides in treatment, and our change in attitude that have brought us where we are today, and [will] take us further.”
Camden County Jail Population Manager Sharon Bean said 71 percent of inmates reported “active substance use at time of admission,” and 47 percent reported active opioid use.
“At least 3,556 individuals are leaving each year and returning to their communities with a reported opioid use,” Bean said. “This is our reality.
“It’s not uncommon for people to be under the influence when they commit offenses, and to commit offenses to support their drug habits,” she said.
“We expect to offer hope, opportunity, and a second chance to individuals.”
Camden City resident Jose Laguer, who entered the MAT program during his incarceration at the county jail, said it’s “a step to get you clean before you get out there.
“It does work if you work it,” he said.
“It’s not drugs out there no more, it’s death. I don’t want to die.”
Laguer will get his fifth monthly Vivitrol shot in March, and hopes one day to not need it any longer.
He receives that care at Project H.O.P.E., where he also participates in confidential group therapy twice a week.
“We sit down, and we share,” Laguer said. “It stays in the building; it stays with us.”
Project H.O.P.E. Chief Medical Officer Lynda Bascelli said that MAT programs typically boast a 30-percent retention rate that varies with the maintenance medications administered.
Vivitrol is a monthly injectable version of the drug naltrexone, which Bascelli said reduces cravings and prevents relapses in people addicted to opioids or alcohol.
The difficulty in administering it comes in finding a seven-to-10-day window in which the addicted person isn’t using, she said.
Comparatively, suboxone can be administered within a 12-to-36-hour window of sobriety, but it has “a ceiling effect,” Bascelli said.
“It sits in [opioid] receptors and prevents anyone from OD’ing, and eliminates cravings and withdrawal symptoms,” she said.
People addicted to opioids aren’t using the drugs to get high, Bascelli said; “they’re using to prevent the pain of withdrawal.” With maintenance medications and behavioral therapy, patients can get their body chemistry regulated enough to change their circumstances.
“When somebody’s in withdrawal and you give them Suboxone, they feel normal,” she said.
“It’s a stunning thing to see.”
