Grant Funds Opioid-addiction Treatment in Two County Jails

AMHERST — In what could serve as a model for tackling one of the nation’s top public-health crises, a UMass Amherst epidemiology researcher is teaming up with two Western Mass. sheriff’s offices to design, implement, and study an opioid-treatment program for jail detainees in Franklin and Hampshire counties.

Funded with a $1.5 million grant from the federal Substance Abuse and Mental Health Services Administration, the three-year project aims to deliver medications to some 500 detainees who agree to treatment, and connect them to follow-up care through a comprehensive community re-entry program after their release. 

Elizabeth Evans, assistant professor in the School of Public Health and Health Sciences and one of the grant recipients, will collect data from all the stakeholders to measure the project’s outcomes. “The idea is to distill the lessons learned into a playbook or guide that can be used in jails in Massachusetts and across the nation,” she said.

The opioid crisis has grown so severe that Americans are now more likely to die from an unintentional opioid overdose than in a vehicle crash or any other accident, according to the National Safety Council.

Opioid addiction “is probably the issue of the 21st century in terms of public health,” Evans said, and the project reflects a shift in the approach to addressing the crisis. “Evidence supports the use of medications to treat opioid-use disorder. This model signifies a willingness of the sheriffs to deliver care to reduce recidivism and to save people’s lives.”

Evans will help Franklin County Sheriff Christopher Donelan, Assistant Superintendent Ed Hayes, and their staff expand and formalize the groundbreaking opioid treatment they began offering inmates in 2015 at the county jail in Greenfield. She also will work with Hampshire County Sheriff Patrick Cahillane, Assistant Superintendent Melinda Cady, and their staff to implement the same program in the Northampton jail. 

The location of the rural counties along Interstate 91 leaves residents particularly exposed to the effects of opioid trafficking. For many of the jail detainees, it will be their first opportunity to receive evidence-based care for their disorder, Evans said. “This is a health condition. And this is a very vulnerable population.”

Each of the jails has a medical director who assesses the need for treatment, prescribes the medication, and monitors the detainees who receive it. An estimated 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of inmates at both jails report having an opioid problem, Evans said, and most are willing to receive treatment, which can begin in as few as four days after arrest.

The treatment medications include Suboxone, which contains buprenorphine and naloxone to help ease cravings and the severe, flu-like symptoms associated with withdrawal; and Vivitrol, an opiate-blocker given as an injection that lasts about a month. Jail authorities also are seeking DEA approval to offer methadone, a synthetic opioid commonly used to treat opioid-use disorder.

“People who experience withdrawal develop a fear of ever experiencing that again,” Evans said, which helps explain both the cycle of addiction and the high risk of overdose for detainees following their release from jail.

Franklin and Hampshire counties are among seven in the Commonwealth in a pilot program mandated by the Massachusetts Legislature to start offering medication to inmates with opioid-use disorder by September. Evans said the data gathered from the three-year project in Franklin and Hampshire counties may inform the Commonwealth’s burgeoning plan for jail-based opioid addiction treatment.

“Jails used to be all about public safety,” she said. “Now they are taking on a public-health role. This has potential benefits to both the incarcerated people and to us as a society.”