Kansas prisons use buprenorphine and naltrexone to fight drug overdose epidemic | KCUR 89.3

A recent decision to let people continue drug treatment while in the Sedgwick County Jail in Wichita reflects a significant shift in thinking among Kansas sheriffs’ offices that is gaining momentum.

Sedgwick officials are no longer removing people from their prescriptions for medications such as buprenorphine when he is imprisoned.

No one keeps track of how many prisons in Kansas allow inmates with opioid or alcohol addictions to receive the combination of medication and counseling that can help them.

But at the national level, only a fraction of prisons do, according to the researchers.

Sedgwick’s joins at least a few other Kansas prisons that do, including one in Crawford County in southeastern Kansas.

“I mean, something has to change,” Crawford County Sheriff Danny Smith said of the decision to allow drug treatment. “Otherwise it’s just a revolving door all the time.”

Studies suggest two-thirds of prisoners have substance use disorders. Allowing the treatment of incarcerated people aims to break the cycle of incarceration and save lives.

Fatal overdoses have skyrocketed during the pandemic in Kansas and nationwide, driven largely by dealers selling fentanyl-containing drugs. Adding methamphetamine, cocaine, or oxycodone with this synthetic opioid makes these substances even more potent and addictive, but also easily fatal.

When a drug addict gets out of jail or jail, they face a high risk of overdose shortly after his release.

A few years ago, Smith got a call from the Southeast Kansas Community Health Center. The center had funds to start a treatment program for the 108-bed prison, if Smith allowed it.

“Honestly,” Smith said, “our willingness to use our facility for this is a no-brainer.”

The program launched in August 2020. He hopes for a “ripple effect” that will help people heal, find jobs, repair family relationships and avoid prison.

Since the start of the program in August 2020, 207 incarcerated people have volunteered. Treatment is not court-ordered or part of probation agreements. Most continued their care after their release from prison.

Tanner’s story

Doctors prescribe medication to reduce cravings for opioids or alcohol, relieve withdrawal symptoms, and even keep the brain from getting high on drugs like oxycodone and heroin.

Typically, treatment involves buprenorphine, methadone, or naltrexone.

Tanner, a recovering Wichita resident, said that was instrumental for him. (Kansas News Service does not use his last name to protect his privacy.)

He first encountered opioids over a decade ago, shortly after graduating from high school.

A doctor sent his friend home after surgery with painkillers – a prescription so ample the friend shared them with others.

Once the pills ran out, Tanner and his friends started looking elsewhere for opioids.

His use spiraled out of control, particularly after a friend overdosed on heroin and died. This prompted Tanner to get high more and more often.

“The depression and all of that started to set in pretty heavily,” he said. “Wanting to mask feelings of hurt, pain, guilt.”

Tanner robbed relatives and his workplace to buy drugs and eventually landed in jail.

After several years, he started treatment in 2012 with a combination of counseling and medication, and felt relief.

He once tried to get high while taking his new prescription, but felt nothing.

“Why waste my money (on opioids), when I won’t be able to feel anything from it?” he said. “There is no euphoria. There is nothing. I mean, that’s the most important thing – if you take the meds right.

Treatment in prisons and prisons

Traditionally, however, many jails and prisons across the country do not allow drugs that combat drug and alcohol addiction.

This means people cannot contact a doctor to start treatment while they are incarcerated.

It also means that people who were already in treatment programs before being locked down lose access to care while in lockdown.

Things change slowly.

Health professionals and counselors who work with addiction have been pushing for quality care based on decades of research. And civil rights lawyers have filed lawsuits that have resulted in settlements or court orders.

In 2019, a judge ordered a Maine County jail to allow a woman to continue taking buprenorphine during her 40-day sentence.

In the same year, the American Civil Liberties Union of Kansas and the ACLU of Missouri sued the federal prison system for refusing medication to a man sentenced to serve time at Leavenworth Penitentiary. Two days later, the Federal Bureau of Prisons agreed to let him continue buprenorphine.

Kansas county jails that allow the drugs say they are getting phone calls from other sheriffs interested in following suit.

Recently, Sedgwick County Jail began letting people continue on methadone and similar drugs after being booked. Previously, only pregnant women were allowed to do so.

“Our prisons are full of people who are our families, our friends and our neighbors,” said Colonel Jared Schechter, the prison administrator. “If they make a mistake and break a law or have a probation violation and end up in jail for a short time, should they be taken off this drug that helps them with their addiction?”

“That’s probably not the best way to help them reintegrate into the community,” he said.

United States Drug Enforcement Administration

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Fake oxycodone pills often contain fentanyl.

For now, the change only applies to people who have started treatment before go to jail. But the sheriff’s office hopes to expand care to anyone who wants to start treatment after go to jail and study the cost.

Groups that help people in recovery see this as a positive step, but want to see more efforts to treat people outside of jails and prisons and to prevent addiction altogether.

“From an economic perspective, there’s certainly a strong case to be made here for MAT (drug therapy) within the prison system,” said Ngoc Vuong, a community mobilizer for Partners for Wichita. “But I would also say, MAT as an alternative to incarceration in the first place.”

Partners for Wichita operates a Safe Streets program to combat addiction and overdose.

Additionally, criminal justice researchers say prisons and jails that provide drug treatment often limit access in practice. Or they limit inmates to naltrexone, for example, even when a different prescription might work better.

Since last year, the marshall project found that very few federal inmates who could benefit from it actually receive medication for their substance use disorders.

The Marshall Project also found that many state prison systems, including Kansas’s, limit options or access to drugs in one way or another.

A spokeswoman for the Kansas Department of Corrections said inmates can continue to take addiction medication after entering prison. And others may undergo a medical evaluation to possibly begin treatment.

Connecting people to medical care providers

Daniel Warren, a doctor who treats drug addiction, welcomes the Sedgwick County Jail’s new approach to drug treatment.

“It’s a big development,” said Warren, a professor at the University of Kansas School of Medicine in Wichita. “An overdose after leaving incarceration is its own kind of public health epidemic…Keeping people on buprenorphine while they’re incarcerated is something really important.”

And when people come out of jail, they need to come away with clear links to long-term help.

“There are ways to connect people to care afterwards that don’t have to be extremely difficult,” Warren said.

Some treatment programs have grants to help people who cannot afford treatment, and staff who can meet people before they are released from prison to arrange access to treatment and medication.

That’s the case at Douglas County Jail, where people can start drug treatment and work with a case manager who supports them for six months or more after they get out of jail.

Carrie Neis is leading these efforts.

“Everyone comes into recovery at different stages,” she said. “Sometimes a person may need hospital treatment just once… Some people, it just doesn’t happen that way.”

Most people are successful in the long run recover from addictionalthough the process often takes years and involves relapses.

“It’s a huge need,” Neis said. “People coming in and out of our facility, if they’re ready and willing to work, then we’re there for them and can get them where they need to go.

Celia Llopis-Jepsen reports on consumer health for the Kansas News Service. You can follow her on Twitter @celia_LJ or email her at celia(at)kcur(dot)org.

The Kansas News Service is a collaboration between KCUR, Kansas Public Radio, KMUW, and High Plains Public Radio focused on health, the social determinants of health, and how they relate to public policy.

Kansas News Service stories and photos may be republished by news outlets free of charge with proper attribution and a link to ksnewsservice.org.

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