|Health Officials Talk Substance Abuse From Jail to Recovery|
|By Andy McKeever, iBerkshires Staff|
05:27PM / Wednesday, May 17, 2017
|The panel was just the latest put together by the Central County Rx/Heroin Work Group.|
Alan Bianchi said the Berkshire County sheriff's office focuses on helping the 'whole' person to prepare inmates for life outside of the jail. The hope is the inmate won't end up back in the Berkshire County House of Correction in the future.
DALTON, Mass. — Where does the system fail from the time an addict is arrested to well after leaving jail?
That's what Marisa Hebble, of the executive office of the trial court, wants to not only answer but fix. She is heading the Community Justice Project, which focuses on "sequential intercept," essentially every point through the process someone struggling with addiction faces in the criminal justice system.
"The whole overall goal is to identify someone's needs as early as possible," Hebble said.
The project is identifying the needs of an addict from the start of the process to the finish in an attempt to create a system which prevents them from constantly recycling through the system, or ending up even deeper in the crime. She recently came out to Pittsfield to run a two-day workshop with justice officials and is working to fill those gaps.
The process starts with an arrest. Dalton Police Officer Diana Strout said the majority of the substance-abused related crime is larceny of jewelry, credit cards, or checks.
"We're seeing grandma's jewelry and grandpa's wedding ring stolen. And it is gone because the grandson has a drug addiction," Strout said.
The police are also first responders in Dalton and she told the story of a drug overdose in a "very public place" and she didn't have the overdose-reversing drug Narcan. Bystanders were filming it and yelling at them, asking why they weren't using it. She said it is difficult to watch those videos, knowing that there was nothing more she could do.
"I was very pro-Narcan in our department and vocally so," Strout said.
The Dalton Police recently received a grant to start carrying it.
"If I can be more effective in doing my job and save someone's life, I'm going to do it. It is not me to judge your life choices," Strout said.
Those responses come with risks, too. In Ohio recently, an officer making a drug bust ended up with some laced fentanyl on his shirt. Later in the day, he instinctually brushed it off and overdosed. Strout has reached into vehicles she pulled over to come inches away from stabbing herself on a syringe.
"We go into these traffic stops and we have no idea what we are getting into," Strout said.
But when it comes to solving the drug problem, she said officers are just a "Band-Aid." After an arrest, the addict gets passed onto courts and jails.
"We're like a quick hit and gone. You guys fight this every day," she said. "We are kind of just a Band-Aid."
Attorney Jennifer Tyne, district court supervisor heading the public defender's office, is often the next step. In her office there a social service advocate. When a client comes in, the office does its best to help.
"We're very client-centered. My job is to defend the client," Tyne said, adding that many times courts or police do not recognize that the individual has an addiction. "I also look at the whole client, what else does this person need?"
The social service advocate makes the connections with various services from housing to jobs to addiction treatment. The office works "heavily" with the Brien Center to get those clients into drug treatment programs.
But Tyne says that's where many of the gaps start. She says there is a massive gap in the number of long-term residential treatment centers. Often the clients end up being sent out of the county, which ups the failure rate because family and friends are so far away.
"We want to address what the underlying problem is," Tyne said.
When the client's day in court finally comes, however, there are typically two ways to go when it comes to a plea: jail or probation. She says if the clients go to jail, they lose their spot in line waiting for treatment programs and interrupt whatever daily program the client is doing.
Probation, however, nearly always comes with a condition that the person does not use drugs or alcohol. But those who have substance abuse disorders will likely relapse because recovery often takes multiple attempts.
"You hope for them and root for them but I also really have to explain to them what it means to be on probation," Tyne said.
She feels those conditions shouldn't be placed because failing a drug test is punishing a person for being an addict. She cited a 1962 case in which the U.S. Supreme Court ruled against the state of California for having a law against being an addict.
"It is still a status offense to have a substance abuse disorder and people are still going to jail for it," Tyne said of the probation conditions.
Only 20 percent of the cases come before her though and she says private attorneys have the ability to petition the judge for funds to hire a social worker. She'd been pushing for more of that to help get more into treatment.
If the client goes to jail, then the person falls under the oversight of Alan Bianchi, of the Berkshire County sheriff's office. Bianchi heads an array of programs aimed to reduce recidivism.
"It is the sheriff's believe in order to really heal a person and get them to be better, you need to address the whole person," Bianchi said.
The office has been expanding its offerings to inmates. It has a wide range of religious activities and collaborates with Williams College and Berkshire Community College for courses to get the inmates certified to work after release. It also offers high school diploma equivalency programs and computer classes.
For work, the House of Correction will place an inmate in the kitchen and Canyon Ranch sends executive chefs to help teach and get them ServSafe certified. The inmates can take custodial maintenance classes and some can receive a work release to be employed in the community and start saving money for when they are released.
All of that is hoped to prepare the inmate to go back into the world in a better place than when he came into the jail. The hope is that the inmate will go free and not be sent back.
When it comes to addiction, Bianchi said there are more than 70 addiction and self-help groups meeting in a month. The trick for the House of Correction is that the inmates are sent for different lengths of time.
"You really need to set up the programs in a way that is progressive," Bianchi said.
The jail has pieced together a series of programs with varying lengths. The department launched a short-term one for those who are awaiting pretrial, which is only 21 days and aims to help the addict understand the impact the drugs are having and what is needed to become clean. From there, there is another program in which the Brien Center sends substance abuse counselors to the jail to work with the addict.
Then there are more intensive programs. Bianchi said those intensive programs have been working. Only two who went through the programs relapsed and one non-fatal overdose.
"It is always full. It is a 10-person group and we serviced last year 114 people," he said. "Out of the 114, 111 of them are still doing well."
Once the inmates leave, Bianchi said, "the longer we maintain contact with them after they leave, the better they seem to do." The jailers enter the addict's life at a vulnerable time and try to build trust with the inmate. The House of Correction has a pre-release center on Second Street in Pittsfield that is staffed to help those ex-inmates adjust back into the world. That includes holding support meetings and educational tutoring.
"It is a pretty vibrant place," Bianchi said.
Before leaving, some of them start Vivitrol treatments. The sheriff's office has been coordinating the effort with the Brien Center for those ongoing treatments.
"Vivitrol can be life-saving for that group of people," said Dr. Jennifer Michaels of the Brien Center.
The drug is an opioid blocker injection that lasts a month. Jessica Kemp runs that particular program and said it is a better alternative than Suboxone or methadone.
"There is no abuse potential. There is no street value for it, and there is no withdrawal," Kemp said.
The risk with that, however, is if a patient attempts to "override" the blocker. That could lead to an overdose. And, she said there is a stringent process to make sure the patient can take it - particularly testing of the liver functions. She says the patients should be on it for a minimum of a year.
"We spend a lot of time making sure the patients we treat with vitriol are the right patients," Kemp said.
Kemp said there have been different responses, and some have even reported cravings in the final week. She says at times the center has given out a pill for that final week, but sometimes it may just be psychological.
Those leaving jail are sent to the Brien Center within a few days, if not the same day, to be set up with treatment.
According to Jennifer Kimball, who heads the public health collaboration through Berkshire Regional Planning Commission, addicts who leave jail are 56 percent more likely to overdose. That's why making that immediate connection with a treatment center outside of the jail is so important.
"We want to meet the needs of the person. We do not do cookie-cutter treatment," Michaels said.
Vivitrol is only one recovery option the center offers. It offers a menu of options to fit the needs to the client and goes as far as recently expanding a community outreach program to be able to bring specialists to the home, encouraging and keeping the recovering addict on track.
"We're realizing that having that outreach worker can be more powerful than seeing a therapist or me," Michaels said.
Berkshire Community Action Council also plays a role in combating the epidemic. Bryan House talked about Project Reconnect, which is a youth workforce development meeting for at-risk youth. He said that program serves ages 16 to 25 and helps connects children with jobs or education.
BCAC has a primary mission of addressing poverty. House said his work is supporting the work the Brien Center is doing by addressing other needs for recovering addicts. The organization has job training, and fuel assistance, and recently launched a program to help get those in poverty to owning cars. The organization doesn't offer direct programming to recovering addicts but helps in numerous other ways.
"We are there as that sort of support partner for that sort of work going on on the front lines," House said. "If it is connected to poverty in the county, we want to be part of the conversation."
Those who spoke were all part of the latest discussion among the Central County Rx/Heroin Work Group. Previous meetings focused on Narcan with input from first responders and those involved in prevention in schools.
"It is such a complex and broad problem affecting our entire community," said Gina Armstrong, Pittsfield's Health Director and one of the facilitators of the group. "It does take all of us. We all have a very important role to play in addressing the problem."