$ 1.5 million grant to develop an opioid treatment program for prison inmates

University of Mbadachusetts Epidemiologist Amherst Partners with Two Sheriff's Offices in Western Mbadachusetts to Design, Implement and Study an Opioid Treatment Program for Franklin and County Inmates from Hampshire.

Funded with a $ 1.5 million grant from the Federal Administration for Abuse and Mental Health Services, this three-year project aims to provide medication to some 500 inmates who agree to treatment and linking them to a community reintegration program.

Elizabeth Evans, Assistant Professor at the School of Public Health and Health Sciences and one of the recipients of the grant, will collect data from all stakeholders to measure project results. "The idea is to summarize the lessons learned in a game manual or guide that can be used in prisons in Mbadachusetts and across the country," Evans said.

The opioid crisis has become so severe that Americans are now more likely to die from an unintended opioid overdose than in a traffic accident or other accident, according to the National Security Council.

"Opioid addiction" is probably the 21st century issue in terms of public health, Evans said, and the project reflects a shift in approach in managing the crisis. "Evidence supports the use of drugs to treat opioid-related disorders, a testament to Sheriffs' willingness to provide care to reduce recurrence and save lives," she said. .

Evans will help Franklin County Sheriff, Christopher Donelan, Deputy Superintendent Ed Hayes and their staff to flesh out and formalize the revolutionary opioid treatment that they began offering to detainees in 2015 at Greenfield County Jail. She will also work with Hampshire County Sheriff Patrick Cahillane, Deputy Superintendent Melinda Cady and their staff to implement the same program in Northampton Prison.

The establishment of rural counties along Interstate 91 exposes residents to the effects of opioid trafficking. For many inmates, this will be their first opportunity to receive evidence-based care for their disorder, says Evans. "It's a health problem," she says. "And it's a very vulnerable population."

Each prison has a medical director who badesses the need for treatment, prescribes the drug and monitors the inmates who receive it. According to Evans, about 40% of inmates in both prisons report an opioid problem and most are willing to receive treatment, which can begin only four days after their arrest.

Treatment medications include Suboxone, which contains buprenorphine and naloxone to help relieve cravings and severe influenza-like symptoms badociated with weaning; and Vivitrol, a blocked opiootherapeutic administered as an injection lasting approximately one month. Prison authorities are also seeking authorization from the DEA to offer methadone, a synthetic opioid commonly used to treat opioid-related disorders.

"People who are suffering from withdrawal develop the fear of experiencing it again," says Evans, which explains both the cycle of addiction and the high risk of overdose for inmates after they leave prison.

According to a report from the Mbadachusetts Department of Public Health published in 2018, the rate of opioid overdose deaths is 120 times higher among newly released inmates than among other adults. And the first month after the release is a critical moment.

"We recognize that the period after release from jail is a time of high risk of overdose and opioid deaths," said Evans. "The tolerance of prisoners changes and their bodies can not withstand the same amount of substances as before they are incarcerated, and they often resume their use at the same level, which becomes a deadly dose for them."

That's why connecting people to drug providers and social services after they get out of jail is a crucial part of the program, says Evans.

Franklin and Hampshire counties are among the seven Commonwealth countries participating in a pilot program mandated by the Mbadachusetts legislature to begin offering drugs to prisoners with opioid use disorder from now until September. According to Evans, data from the three-year Franklin and Hampshire County project could inform the Commonwealth's growing plan for the treatment of opioid addiction in prison.

"Before, prisons were focused on public safety," says Evans. "Now they have a role in public health, which has potential benefits for the incarcerated and for us as a society."