A rural jail in Western Massachusetts is set to become the state's first correctional facility with a methadone clinic for opioid addiction treatment. The license was given as sheriffs in seven counties prepare for a four-year pilot program that will make medications to treat opioid use disorder available in jails across the state.
Franklin County Sheriff Christopher Donelan said Tuesday his office received state and federal approvals to establish a methadone clinic at its jail in Greenfield. The jail will soon offer all three federally-approved opioid treatment medications onsite: Suboxone, Vivitrol and methadone.
The seven-county pilot program is part of a larger initiative signed into law by Gov. Charlie Baker in August of last year, H.4742, or “An Act for prevention and access to appropriate care and treatment of addiction.” The pilot will allow county jails in Middlesex, Hampden, Hampshire, Franklin, Suffolk, Norfolk and Essex counties to dispense opioid treatment medications for at least four years.
Studies show that drug overdose is the leading cause of death following release from the criminal justice system internationally, the majority of these overdose deaths are opioid related, and people released from jails or prisons are particularly vulnerable. A 2010 study showed that individuals released from a prison in Washington state had 129 times greater risk of drug overdose in the first two weeks after being released compared to the general population.
The Greenfield jail will establish a clinic where the substances can be both stored and administered. Other county jails will have methadone and other medications brought in on a regular basis to help incarcerated people suffering from opioid use disorder.
Middlesex County Sheriff Peter Koutoujian says this approach represents a shift in response to the opioid crisis.
"We know what we have done has not has not worked," he said. "We cannot arrest and incarcerate our way out of substance use disorder."
Koutoujian’s office has been running its own program, the Medication Assisted Treatment and Directed Opioid Recovery (MATADOR) Program, since 2015. The new pilot program will mean an extension of benefits for some counties. For Koutoujian’s county, it will mean adding methadone as a treatment option.
“We've had well over 500 people go through our program, and the results have been phenomenal,” Koutoujian said. “This [pilot] is taking Massachusetts to a new level of leadership in corrections with regard to substance use disorder and harm reduction.”
Koutoujian added that he hopes the new program will continue beyond four years.
“We need to meet individuals where they're at in their recovery,” Koutoujian said. “And if we're not willing to take a chance, then we're not going to be able to treat this disease and keep people alive in the way that we need to in corrections.”
Programs like the pilot in Massachusetts are also gaining national support. In June, Sen. Ed Markey (D-Mass.) and Sen. Lisa Murkowski (R-Alaska) introduced the Community Re-Entry through Addiction Treatment to Enhance (CREATE) Opportunities Act, which would expand medication-assisted treatment through funding from the U.S. Justice Department for state-run programs in jails and prisons.
“Our local jails are on the front lines of the response to the nation’s opioid overdose crisis,” Markey said in a statement. “Too often, our local jails witness some of the most devastating impacts of the opioid crisis, but don’t have the resources to mount a robust and appropriate response.”
Koutoujian says he’s hoping the pilot will help sheriffs around the state gather data and determine the best course of action to combat the ongoing epidemic.
“Everyone knows someone that has died as a result of an overdose,” he said. “This is not just about public safety, this is also about corrections providing harm reduction opportunities.”
He added that attitudes are changing around once-controversial medications like Suboxone and methadone, which are both opioids. He says fear that the drugs may be sold or abused in jails is gradually being replaced by a sense of necessity.
“Society has moved on beyond the point where there was an initial reticence or antipathy towards a therapy like methadone or suboxone,” Koutoujian said. “They see how it's impacting the lives of their community, their neighbors, and their own families. … I think that society is actually eager for us to do this, and even just five years ago this was not the case.”
