State Expands Addiction Treatment for Prisoners

Lilo H. Stainton | August 9, 2018 | Health Care
Eighty percent of inmates in Garden State were under the influence of drugs when they committed the crime that put them behind bars

At John Brooks Recovery Center, NJ Health Commissioner Dr. Shereef Elnahal (top left) visits van that's used to deliver opioid treatment services to inmates.
New Jersey is expanding effective addiction-treatment options for state, county and local prisoners, a population that has a high incidence of opioid use, is often rearrested for drug-related crimes, and is far more likely than most to die of an overdose after leaving jail.

State health and law-enforcement leaders highlighted the success of these programs to date and touted new investments in them during a tour Monday of an addiction-recovery facility near Atlantic City, which has used a customized camper van to provide addiction treatment to nearly 350 inmates over the past year.

As many as eight in 10 inmates is diagnosed with a substance use disorder, studies show, and 80 percent of the Garden State’s more than 40,000 prisoners were under the influence when they committed the crime that landed them behind bars, officials said. Three-quarters of these individuals relapse within three months of leaving jail, they added, and they are more than 100 times more likely to die of an opioid overdose than the public at large.

The state Department of Corrections will invest an additional $1.7 million in established treatment therapies that will be provided through jail programs in ten counties, officials said. The Office of the Attorney General is also working to divert more nonviolent drug users from criminal prosecution and prison, expanding use of the state’s existing drug-court program and creating new, community-based collaborations to help local law enforcement steer low-level criminals into treatment, officials said.

Prescription drugs to reduce cravings

In addition, corrections and health officials have joined forces to form expert teams that can connect inmates leaving prison with services like housing, employment, and addiction treatment to help stabilize their re-entry into society. These teams are expected to reach some 600 individuals, one in three of whom are involved in an addiction treatment program, according to the state. Nonprofit organizations are also at work in Camden, Jersey City and other communities to help local officials improve the health and welfare of former prisoners.

Mid-State Correctional Facility in Fort Dix is dedicated to addiction treatment.
Hundreds of individuals incarcerated in state prisons have already benefited from addiction programs initiated in recent years, including medication assisted therapy (MAT) — a best-practice protocol that involves prescription drugs to reduce cravings and other addictive behaviors. Last spring, under former Gov. Chris Christie, New Jersey launched what may have been the first prison dedicated to addiction treatment, at the former Mid-State Correctional Facility in Burlington County, and has since enhanced addiction-treatment options at the Edna Mahan Correctional Facility in Hunterdon County.

New Jersey is now one of a small but growing number of states, including Massachusetts and Rhode Island, to offer some form of MAT within its correctional system. Officials here said it has led to a 60 percent decline in overdoses among those with addiction issues who have done time.

State health commissioner Dr. Shereef Elnahal, who has made a priority of battling the state’s opioid epidemic — which is on track to claim at least 3,000 lives this year — sees addressing addiction behind bars as a critical component of the public health response. He would like to see more MAT programs at prison facilities around the state, through partnerships between corrections officials and nonprofit providers, and the state is seeking additional federal dollars to help support re-entry programs.

Opioid addiction at root of a lot of crime

Elnahal said the MAT program has been more effective than other forms of therapy among inmates, with 91 percent of individuals successfully completing the MAT course versus 50 percent who did not receive pharmaceutical assistance to avoid relapse. “These statistics are powerful testimony to the value of MAT,” he said.

Elnahal praised the work of his team and others in Gov. Phil Murphy’s administration for their “bold steps” to integrate MAT into “multiple stages of one’s journey through the criminal justice system.” The program reflects their understanding “that opioid addiction is the root cause of a large portion of criminal behavior and recidivism,” he said.

Acting state corrections commissioner Marcus O. Hicks said he also was pleased with the initiative’s results. “We believe that MAT, in conjunction with behavior therapy, is a beneficial resource for our inmates that will lead to successful reentry back into society,” Hicks said.

Former Gov. Jim McGreevey, center, at the recent launch of Monmouth County Correctional Institution's new addiction-treatment program for inmates.
Improving inmate access to addiction treatment — and other healthcare and support services — has also been a focus of the New Jersey Reentry Corp. A nonprofit led by former Gov. Jim McGreevey, it runs programs to help former prisoners in a half-dozen cities. A report released by the group in September 2017 suggested that one-third of the state’s inmates suffer from a mental or physical disability and at least half have a chronic health condition other than addiction.

In addition, the Camden County Correctional Facility has used a federal grant to create the Co-Occuring Reentry Program (CORP), which links prisoners with case managers who can help them arrange counseling, treatment — including MAT — and other services in advance of their release.

Helping people get back on their feet

The effort involves clinical providers from Cooper University Health Care and various nonprofit organizations, including the Camden Coalition of Healthcare Providers, which created a shared health-records database that now includes information from the county jail’s clinic, and runs a program designed to keep at-risk individuals from entering or returning to prison.

“People who enter our jails bring with them their medical and social needs, and that can include substance use disorder. When clinicians can give medically assisted treatment in jail, we begin to bridge a dangerous gap in the continuum of care,” explained Victor Murray, the Camden Coalition’s director of Care Management Initiatives. (A recent coalition study found that two out of three people arrested in Camden had visited a local emergency room in recent years, and half had made several trips.)

“Just as importantly, the work that organizations like Project H.O.P.E.” — another nonprofit involved in the Camden CORP initiative — “are doing to keep that treatment going on the outside can help people get back on their feet and break the cycles of addiction, hospitalization, and incarceration,” Murray added.

Camden County will also receive a share of the $1.7 million in state corrections funding for MAT programs, officials said; Money will also go to corrections offices in Bergen, Burlington, Hudson, Middlesex, Passaic, Salem, Somerset, Union, and Warren counties.

The Atlantic County program, operated by the John Brooks Recovery Center, includes the mobile MAT clinic and other initiatives — also available to nonincarcerated patients — funded with $3 million provided by the state’s Department of Human Services. The van, which offers Methadone and other MAT options depending on the patient, is one of five rolling addiction clinics statewide, but the only one that services the prison population.

Atlantic County Superior Court Judge Mark Sandson said the mobile program provides health benefits for prisoners, helps them avoid other drug-related sentences in state prison, and serves the public as well. “I am certain we have saved many lives and have saved our New Jersey citizens countless tax dollars in having this capacity, thus avoiding, in most cases, state prison sentences,” he said.