State Expands Addiction Treatment Programs in County Jails

Lilo H. Stainton | September 23, 2019 | Health Care
New Jersey is investing $8 million to improve access to medication-assisted therapy for prisoners with opioid use disorders

New Jersey will invest $8 million to expand quality treatment for prisoners in its county jails with opioid use disorders, a population that is considered especially at risk for relapse and overdose.

Through the project, announced Friday, officials from the state’s departments of Human Services, Health, and Corrections will work with representatives from the state’s 21 independently operated county prison systems to improve access to medication-assisted treatment. Also known as MAT, the therapy involves prescription drugs that reduce cravings and addictive behavior for patients with opioid addictions.

Some jails in New Jersey are already providing MAT, but it is not universally available. Collectively, these jails house more than 10,000 people who have been charged with a crime, but not sentenced, or are awaiting transfer to another facility, like a state prison.

As many as eight in 10 prisoners in the state have substance use disorders, according to some experts, and most of these were under the influence of drugs when they committed the crime that brought them to jail. Studies show that three-quarters of these individuals are likely to relapse when they leave prison and, as a group, they are 129 times more likely to die of an overdose than the population at large when they return to the community.

Carole Johnson, commissioner, Department of Human Services
“Individuals leaving jail are particularly vulnerable to opioid overdose,” Human Services Commissioner Carole Johnson said Friday at a conference on MAT in Atlantic City. “It is imperative that we treat people with opioid use disorder with the clinical standard of care before they are released and maintain treatment post-release.”

Johnson announced the news during a panel on treatment in prison that featured other state commissioners and prison officials. (This reporter moderated a separate panel at the Atlantic City event.)

The commissioner praised the county wardens for partnering with the state on the new initiative, which is designed to make treatment available in all counties. The money is also to be used to build partnerships with local organizations that can help support prisoners in their recovery when they return to the community, Johnson said.

State prisons already have MAT services

Acting Department of Corrections Commissioner Marcus O. Hicks said the state prison system has also instituted addiction screening, MAT and other treatments, as well as various peer programs; the goals are to help inmates adjust to life behind bars and encourage them to get help for substance use problems. MAT has not always been popular with corrections officials who questioned the need for treatment programs in prison, he conceded, and it has taken work to get staff support for its expansion.

“There is a paradigm shift in the treatment of incarcerated individuals with substance use disorders,” Hicks said.

While welcoming the news of more funding, one panelist said more still must be done to address the high rates of addiction behind bars — and enable prisoners to continue their treatment once they leave jail. “Even if DOC does everything right, you still have nowhere to go for MAT” when you get out of jail, said former Gov. Jim McGreevey, another panelist and leader of the New Jersey Reentry Corporation, which advocates for those returning to the community. “Today’s announcement goes a long way,” he said, “but we have to do so much more.”

Under Gov. Phil Murphy, New Jersey has invested heavily in expanding access to treatment — MAT, in particular — in communities and institutions. Johnson’s department has reduced the Medicaid requirements for patients to get into treatment and trained hundreds of doctors in the prescribing techniques involved, while DOH has enabled paramedics to offer one form of MAT to overdose victims after they have been revived with naloxone, often sold as Narcan.

“At the end of the day, we need to save lives. These medications save lives,” said acting Department of Health Commissioner Judith Persichilli. “Individuals who take them are less likely to die from overdose or other addiction-related causes, less likely to inject drugs or transmit or contract infectious diseases, and more likely to stay in treatment longer and enjoy better long-term outcomes.”

Last year, the Department of Corrections invested $1.7 million to create a pilot program for MAT in multiple counties, modeled in part on work done in Atlantic County through a partnership with the John Brooks Recovery Center. Corrections and health officials also pledged to work together to smooth the return to the community of former prisoners and help them better connect with medical and behavioral health services.

‘We can make a change in someone’s life’

The new funding will allow county officials to build on that foundation. “Each county jail will now be able to provide this well-needed service as part of the change in our day-to-day responsibilities, as we now envision ourselves as a Department of Corrections and Rehabilitation,” said Gloucester County Warden Eugene Caldwell, president of the New Jersey County Jail Association.

Caldwell thanked the New Jersey officials and others, including the state Warden’s Association, for supporting the expansion of MAT. “Each county jail can make a difference, but together with this partnership, we can a make change in someone’s life,” he said.

Perhaps the most passionate plea for expanding the program came from Camden County Jail Warden Karen Taylor, who also took part in the panel; Camden County has created several novel health programs for its inmates, including one that enables it to share medical records with outside facilities in an effort to provide more continuous, effective care.

“If you want to reduce harm, start a (MAT) program,” she said. “If you want to reduce the numbers of deaths in your community, start a program.”

“There’s a lot of bias out there — you have to educate yourself” about how MAT works, Taylor continued. “I encourage you today, forget the bias and misinformation, listen to the science. And the science will tell you, start a program.”