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Stopping the Revolving Door – Could Medication Assisted Treatment in the Jail Help Inmates Suffering Addiction?

Published December 21, 2018
  • HHSA in the News
  • HHSA
  • Medication Assisted Treatment
  • MAT


America’s Prescription Opioid Crisis is narrowing the divide between “us and them.”

This scenario is now commonplace throughout the nation - a person goes to the doctor seeking treatment for a physical issue, such as a back injury, and is prescribed an opioid, like Norco, to help them recover. It seems to be a safe option, but the initial rush or “high” they may get from taking a painkiller has been enough to cause some to spiral deep into addiction. In fact, about 75% of people who develop a heroin addiction first misused a prescription opioid.

For some people, the addiction becomes severe. Heroin has a half-life of about six hours, which means a person could need a “fix” four times a day to stave off the agony of withdrawal. Coping with intense cravings may cause a person to engage in criminal behavior, leading to incarceration and sometimes repeated incarceration.

This is one of the reasons why the newly formed Medication Assisted Treatment (MAT) Collaborative is bringing together local community leaders, medical professionals, law enforcement and corrections officials to explore the possibilities of bringing MAT into our jail.      

The first convening featured several speakers and provided foundational knowledge about the causes of addiction, including Adverse Childhood Experiences, and the basics of how MAT works.

Dr. Greenberg, an E.R. physician at Shasta Regional Medical Center, spoke about addiction medicine and experiences with some of his patients. He has witnessed MAT’s ability to repair the life damaging effects of opioid abuse.

“…we see the revolving door that has become our jail system,” said Dr. Greenberg. “I see the same people over and over again (in the E.R.). I know law enforcement is frustrated because they see the same people over and over. We need to do something different. What we are doing isn’t working. And we know that MAT really does work.”

Keynote speaker, Dr. Judy Martin, Medical Director for the San Francisco Department of Public Health spoke about both the benefits and challenges she has encountered in the 20 years she has spent working with opioid addicted patients and their families.

According to Dr. Martin, research indicates that treating a patient with medication alone increases their chances for a successful recovery by 80 percent as opposed to total abstinence. Those who try to manage their withdrawal with intensive counseling without medication may have minimal success. For those who attempt recovery with counseling, only 10 percent haven’t relapsed after one-year.

“We should be using a medication-first approach,” said Dr. Martin.

She also pointed out that there is significant evidence that Medication Assisted Treatment drastically reduces criminal behavior and the risk of disease transmission.

Overall, those in attendance were supportive of starting a MAT program, but there was concern about “logistics”. A discussion of action steps, led by HHSA Director Donnell Ewert, revealed the complexity of implementing the treatment in our justice system. Issues brought up ranged from funding and facility space to patient compliance.

Acknowledging their hesitation, Donnell Ewert said, “I think it’s important for us to say that MAT is not a magic bullet. This is just one piece.”

Still, he encouraged the Collaborative to view MAT as an opportunity to interrupt the cycle of addiction and start seeing some success in our community.

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