St. Louis County has been chosen as one of 15 jurisdictions in the country for a program aimed at expanding treatment for people in jail who have opioid use disorder.
Specifically, the program will help the county create a plan, in partnership with area health care providers, to offer medication assisted treatment (MAT) for people in or recently released from the county jail.
The program is called Planning Initiative to Build Bridges Between Jail and Community-Based Treatment for Opioid Use Disorder. As part of it, the county will receive expert guidance on how to overcome barriers to providing opioid treatment.
Examples could include transportation challenges, lack of providers and other barriers still to be identified. Representatives from Health Management Associates will visit St. Louis County beginning July 31 to tour the jail, meet with staff and start training.
The County also will receive reimbursement for five staff members to travel to Washington, D.C. next month for further training. Staff will be taught to create treatment guidelines, manage administration of the medications, and educate jail staff about addiction.
The County will then be responsible for developing a plan to ensure people can access treatment following their release from jail.
Nationwide, jails are at the epicenter of the opioid crisis. Tens of thousands of people with opioid use disorder pass through the corrections system each year. But only about 30 of the 3,200 jails in the country offer the opioid medications methadone and buprenorphine, which have been shown by research to be the most effective forms of treatment.
Most individuals instead go through detoxification, which lowers tolerance levels without curbing opioid cravings and dramatically raises the risk that people will overdose after they’re released.
“We know that people going to jail who’ve been using heroin or opioids will have a horrible detox,” said Judge Shaun Floerke, who presides over the South St. Louis County DWI Court and worked with St. Louis County on the grant application. “They will be very sick, often in need of medical care. Even worse, people with an opioid use disorder coming out of jail without medication assisted treatment and solid connections to treatment have a an increased risk of overdose or death.
“People need intervention and treatment. This is another way our community can respond effectively.”
In St. Louis County, jail staff administered a survey this past January and found that on that particular day, 52 percent of inmates self-disclosed that they have used heroin/opioids, and 35 percent stated they used heroin/opioids on a daily basis.
Meanwhile, 11 percent reported they were on a MAT program prior to arrest. These numbers cannot be confirmed as accurate since they were based on self-disclosed figures, but it gives an idea as to the number of individuals who could benefit from medically assisted treatment.
“We have an increasing number of inmates who are telling us when they arrive at the jail that they are using heroin or opioids, or that they are on a MAT program, so this an opportune time to engage in this work as a system,” said Sheriff Ross Litman. “We are talking with key stakeholders, have identified common goals and want to work together to build a continuum of care for those who come to the jail on MAT or are needing MAT, so together we can coordinate ongoing care and connection with treatment upon release from the jail.”
The St. Louis County Jail will ensure individuals coming into jail who are on a MAT program can continue the program and those who get screened for an opioid use disorder and in need of MAT can get started on a MAT program.
The program is a joint initiative of the U.S. Department of Justice, Bureau of Justice Assistance, and Arnold Ventures, a national philanthropy headquartered in Houston, Texas. In addition to supporting efforts to expand treatment for opioid use disorder, the philanthropy is also working to improve the criminal justice system through reforms to policing, pretrial, probation and parole, and reintegration services.
More information about the Planning Initiative to Build Bridges Between Jail and Community-Based Treatment for Opioid Use Disorder can be found online at https://www.arnoldventures.org/work/the-opioid-epidemic.