Western Virginia Regional Jail to give a shot at recovery to inmates suffering from addiction
The Roanoke Times | July 11, 2018
By Amy Friedenberger
Allen Williams is scared to death of getting out of jail.
The 46-year-old has been abusing substances since he was 10 years old, and landing behind bars at the Western Virginia Regional Jail 23 months ago has led to his longest stretch of staying clean.
“There are no drugs in here, and there are so many drugs out there,” Williams said.
Being on his own will test his resolve to remain clean. Addiction experts and those who work in corrections say the first few weeks after being released are among the most challenging for people with addictions, and without treatment, they are at a higher risk of relapsing and overdosing.
With this understanding, the jail in western Roanoke County is preparing to offer a high-priced injection that staves off opioid and alcohol cravings for a month, giving the former inmates an opportunity to get into treatment to continue their recovery. While limited research is available on the drug’s long-term effectiveness at preventing relapses or reducing recidivism, those who work in corrections are optimistic about the drug’s possibilities in helping people, many of whom are in jail because of their addiction.
“With the opioid crisis, we feel an obligation from the community to help these people as they’re leaving to get away from opioid addiction,” jail Superintendent Bobby Russell said.
Providing treatment
Vivitrol — the brand name for naltrexone — is one of three federally approved treatment drugs for opioid addiction. The U.S. Food and Drug Administration approved the shots in 2006 to treat alcohol dependency, and four years later, it approved the medication to fight opioid addiction.
Vivitrol is non-addictive and non-narcotic and has no street value, which is why jails and corrections departments have increasingly favored it over treatments using methadone or buprenorphine, one of the drugs in Suboxone.
Alkermes, the manufacturer of Vivitrol, has also been open about marketing it to corrections officials who are trying to figure out how to help the opioid users who are filling up their facilities. At least a quarter of the nearly 2.3 million people locked up are addicted to opioids, according to the U.S. Department of Justice. Russell said his jail comes into contact with many people suffering from substance addiction.
“Historically, opiate use disorders weren’t typically seen as medical care or behavioral health or something jails were obligated to offer treatment for,” said Dr. Joshua Lee of New York University’s medical school, a leading researcher on incarceration-based, medication-assisted treatment. “Now there are many more opiate abuse cases, and jails are full of people addicted to opiates.”
A shot of Vivitrol lasts for a month. It blocks opioid receptors so patients will have reduced cravings; even if they use opioids, they won’t be able to get high.
Buprenorphine and methadone, on the other hand, clasp on to opioid receptors and deliver a bit of a painkilling effect, which is why there’s concern among people in criminal justice and corrections that using those two is substituting one drug for another.
Jails also already deal with smuggled Suboxone used by inmates to get high or to help them avoid withdrawal.
Lee said correctional facilities should provide all three, because what works for one person might not work for another, and because someone who gets locked up might want to continue using a certain medication.
“Is one better than nothing? Probably,” Lee said. “Is it good enough? Probably not.”
A Vivitrol shot costs about $1,100. The Western Virginia Regional Jail is paying for the program through a $200,000 grant from the Virginia Department of Criminal Justice Services as well as a match of $67,000 from the jail’s own budget. How or if the program will continue once that grant money runs out is unclear.
Russell said the Western Virginia Regional Jail is the only one in the region he’s aware of that offers Vivitrol.
The Roanoke City Jail doesn’t provide inmates with any form of medication-assisted treatment, but it does have the Alpha program, a rigorous 120-day drug treatment program that’s been offered in the valley’s jails for the past 25 years. Sheriff Tim Allen said he’ll monitor the program at the Western Virginia Regional Jail to see if it’s a service Roanoke could offer.
“Our fundamental goal is to return people back to the streets better than when they came to us,” he said.
Fighting every day
Last week, several men gathered in a room at the regional jail to celebrate their completion of the Alpha program.
“If you don’t change, you’ll be right back here,” Steve Ratfliff, division director of adult and family services for Blue Ridge Behavioral Healthcare, a partner in Alpha, told the men. “You have the power. You have the control. You answer to yourselves and no one else.”
The men shared their stories of recovery, their goals and their fears of what will happen once they’re free.
“I’m waiting to get on the street to find out for sure,” one man said.
“I guess being in jail and off the street helped,” another said. “I have an addiction, but I have to keep fighting it every day.”
The men at the graduation won’t get Vivitrol. The jail is currently screening inmates to receive it.
Vivitrol will only be available to men and women who participate in Alpha. There are about 40 people in the program at a time. Russell said he wants to combine all of the tools he has to give people the best chance at staying clean once they leave.
“The shot alone is not the answer,” Russell said.
The jail works with them to develop a discharge plan to address living arrangements and job opportunities. Together they’ll also develop a strategy for continued substance treatment.
“For a lot of my clients, that transitioning in those first 30 days out of jail is challenging,” said Leigh Ann Reece, the Alpha clinician for women at the jail. “With the overwhelming stress, they have relapses.”
Williams won’t get the shot, so he’s trying to set up a drug-free environment to reduce temptation for when he’s released in December. He plans to stay with his mother, where he said there are no drugs.
Williams’ precipitous tale of drug use began early. He started smoking marijuana when he was a kid. When he had surgery on his back, he got hooked on painkillers. Then he sought heroin, which was cheaper and more accessible. He sold drugs to pay for his drugs. Then the police caught up to him.
He landed in jail and volunteered to join the Alpha program.
“I wanted to straighten out my life,” he said.
Williams said he plans to continue his treatment when he gets out of jail in December.
“It’s easy to say in here you aren’t going to use again, but it’s different when you get out in the streets,” he said.
By Amy Friedenberger
Allen Williams is scared to death of getting out of jail.
The 46-year-old has been abusing substances since he was 10 years old, and landing behind bars at the Western Virginia Regional Jail 23 months ago has led to his longest stretch of staying clean.
“There are no drugs in here, and there are so many drugs out there,” Williams said.
Being on his own will test his resolve to remain clean. Addiction experts and those who work in corrections say the first few weeks after being released are among the most challenging for people with addictions, and without treatment, they are at a higher risk of relapsing and overdosing.
With this understanding, the jail in western Roanoke County is preparing to offer a high-priced injection that staves off opioid and alcohol cravings for a month, giving the former inmates an opportunity to get into treatment to continue their recovery. While limited research is available on the drug’s long-term effectiveness at preventing relapses or reducing recidivism, those who work in corrections are optimistic about the drug’s possibilities in helping people, many of whom are in jail because of their addiction.
“With the opioid crisis, we feel an obligation from the community to help these people as they’re leaving to get away from opioid addiction,” jail Superintendent Bobby Russell said.
Providing treatment
Vivitrol — the brand name for naltrexone — is one of three federally approved treatment drugs for opioid addiction. The U.S. Food and Drug Administration approved the shots in 2006 to treat alcohol dependency, and four years later, it approved the medication to fight opioid addiction.
Vivitrol is non-addictive and non-narcotic and has no street value, which is why jails and corrections departments have increasingly favored it over treatments using methadone or buprenorphine, one of the drugs in Suboxone.
Alkermes, the manufacturer of Vivitrol, has also been open about marketing it to corrections officials who are trying to figure out how to help the opioid users who are filling up their facilities. At least a quarter of the nearly 2.3 million people locked up are addicted to opioids, according to the U.S. Department of Justice. Russell said his jail comes into contact with many people suffering from substance addiction.
“Historically, opiate use disorders weren’t typically seen as medical care or behavioral health or something jails were obligated to offer treatment for,” said Dr. Joshua Lee of New York University’s medical school, a leading researcher on incarceration-based, medication-assisted treatment. “Now there are many more opiate abuse cases, and jails are full of people addicted to opiates.”
A shot of Vivitrol lasts for a month. It blocks opioid receptors so patients will have reduced cravings; even if they use opioids, they won’t be able to get high.
Buprenorphine and methadone, on the other hand, clasp on to opioid receptors and deliver a bit of a painkilling effect, which is why there’s concern among people in criminal justice and corrections that using those two is substituting one drug for another.
Jails also already deal with smuggled Suboxone used by inmates to get high or to help them avoid withdrawal.
Lee said correctional facilities should provide all three, because what works for one person might not work for another, and because someone who gets locked up might want to continue using a certain medication.
“Is one better than nothing? Probably,” Lee said. “Is it good enough? Probably not.”
A Vivitrol shot costs about $1,100. The Western Virginia Regional Jail is paying for the program through a $200,000 grant from the Virginia Department of Criminal Justice Services as well as a match of $67,000 from the jail’s own budget. How or if the program will continue once that grant money runs out is unclear.
Russell said the Western Virginia Regional Jail is the only one in the region he’s aware of that offers Vivitrol.
The Roanoke City Jail doesn’t provide inmates with any form of medication-assisted treatment, but it does have the Alpha program, a rigorous 120-day drug treatment program that’s been offered in the valley’s jails for the past 25 years. Sheriff Tim Allen said he’ll monitor the program at the Western Virginia Regional Jail to see if it’s a service Roanoke could offer.
“Our fundamental goal is to return people back to the streets better than when they came to us,” he said.
Fighting every day
Last week, several men gathered in a room at the regional jail to celebrate their completion of the Alpha program.
“If you don’t change, you’ll be right back here,” Steve Ratfliff, division director of adult and family services for Blue Ridge Behavioral Healthcare, a partner in Alpha, told the men. “You have the power. You have the control. You answer to yourselves and no one else.”
The men shared their stories of recovery, their goals and their fears of what will happen once they’re free.
“I’m waiting to get on the street to find out for sure,” one man said.
“I guess being in jail and off the street helped,” another said. “I have an addiction, but I have to keep fighting it every day.”
The men at the graduation won’t get Vivitrol. The jail is currently screening inmates to receive it.
Vivitrol will only be available to men and women who participate in Alpha. There are about 40 people in the program at a time. Russell said he wants to combine all of the tools he has to give people the best chance at staying clean once they leave.
“The shot alone is not the answer,” Russell said.
The jail works with them to develop a discharge plan to address living arrangements and job opportunities. Together they’ll also develop a strategy for continued substance treatment.
“For a lot of my clients, that transitioning in those first 30 days out of jail is challenging,” said Leigh Ann Reece, the Alpha clinician for women at the jail. “With the overwhelming stress, they have relapses.”
Williams won’t get the shot, so he’s trying to set up a drug-free environment to reduce temptation for when he’s released in December. He plans to stay with his mother, where he said there are no drugs.
Williams’ precipitous tale of drug use began early. He started smoking marijuana when he was a kid. When he had surgery on his back, he got hooked on painkillers. Then he sought heroin, which was cheaper and more accessible. He sold drugs to pay for his drugs. Then the police caught up to him.
He landed in jail and volunteered to join the Alpha program.
“I wanted to straighten out my life,” he said.
Williams said he plans to continue his treatment when he gets out of jail in December.
“It’s easy to say in here you aren’t going to use again, but it’s different when you get out in the streets,” he said.
