Next fall, five Massachusetts jails will give inmates the option of opioid maintenance therapy using medications like methadone and suboxone.
The pilot program is like one being offered in Rhode Island jails, and they claim it's drastically cutting down overdose deaths after they're released.
For Bill Fox and Anthony Perito, life hasn’t always looked like this.
Both are free men after doing time inside Rhode Island correctional facilities, with opioid addiction a common thread in their convictions.
"I got hooked on them a while ago (painkillers) when my daughter died," Perito said. "That was my first fight with addiction."
Their fight is now to stay clean on the outside, with a new program they started on the inside helping them do that.
"Not only does it help me with my cravings for the opioids, it keeps me focused" Perito said.
They're both taking the prescription opioid suboxone that helps maintain their sobriety in what is called medically assisted treatment, or MAT.
"It doesn't get you high, Fox said. "You feel normal."
Linda Hurley is president and CEO of the non-profit CODAC, which runs behavioral healthcare programs inside Rhode Island's prison.
The state’s department of corrections expanded their MAT program two years ago to all inmates offering methadone and suboxone.
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"This facility sees a lot of the folks that leave the prison, particularly individuals that aren't sure where they're going to go next," Hurley said.
When inmates are released, they transition to one of CODAC’s wellness clinics around the state to continue treatment.
“What we saw between 2016 and 2017 with this new enhanced MAT that we're doing was a 61% decrease in overdose death," Hurley said. "I don't where you can go in medicine and show something of that nature."
Massachusetts is hoping for the same success.
“This is a tremendous problem for our society and it's one we can't arrest or incarcerate our way out of," Middlesex County Sheriff Peter Koutojian said. "We need to treat it."
Middlesex is one of five county houses of corrections participating in the program, with Hampden, Hampshire, Franklin, and Norfolk also involved.
The plan is to have the program started by September 1, 2019, and Koutoujian is hopeful they will roll out the treatment ahead of schedule.
He says they're expanding existing MAT programs by giving inmates more options to opioid maintenance medications like methadone and suboxone.
Currently, Middlesex and other county jails have been giving inmates naltrexone, which helps curb cravings drugs.
Koutoujian says the jail will be tracking progress both inside and the Massachusetts Department of Health will be tracking the inmates once they’re released.
“This is by far the most ambitious, most all-encompassing program right now in the entire country, and the rest of the country is already watching us,” Koutoujian said.
Not all jails in Massachusetts are ready to make the transition, but a new lawsuit may force their hand.
A few weeks ago, a federal judge ordered the Essex County house of corrections to provide methadone to an incoming inmate. The lawsuit brought by the ACLU claimed denying the inmate his medication violated the Americans with Disabilities Act.
Essex County Sheriff Kevin Coppinger will comply with the judge’s order, but is worried future lawsuits would move things too fast. He says the pilot program is set up to figure out the best practices for treatment and security protocols.
“It’s got to be done in the right way at the right time to address all those logistical issues,” Coppinger said.
Defense lawyer Lisa Newman-Polk is an advocate for prisoners struggling with substance use, and was also a mental health worker at Souza-Baranowski Correctional Center for a little over a year.
She believes denying MAT to inmates addicted to opioids is like denying medication for any other mental health disorder,
"We would not deny somebody their anxiety medication, if somebody was experiencing a manic episode or had bipolar disorder," Newman-Polk said. “If you have a diagnosis of any other mental disorder that's deemed in need of treatment, you are provided that mental health treatment in the prison."
It’s a long road ahead for Fox and Perito, and they say it's different this time, and life is better because of their newfound support.
“I look forward to waking up in the morning," Fox said. "It's so much better being sober."
“I want my kids to live a normal life," Perito said. "Try to break the chain while I can. My mom was an IV drug user. I'm trying to be there for my kids."
The judge’s ruling in the Essex case could also play a big role in how other jails across the country deal with opioid maintenance therapy. There are currently lawsuits from the ACLU in Washington and Maine.
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