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This article has nothing to do with Maine, but it is a HUGE step forward for methadone!!

 

A New program Lets Baltimore Jail Inmates Continue Methadone Treatment While They Await Trial.

http://www.baltimoresun.com/news/opinion/ideas/bal-id.methadone17aug17,0,24482.story

By Doug Donovan

August 17, 2008  Every year, an estimated 12,000 heroin addicts are arrested and processed through Baltimore’s downtown booking and pretrial jails. And there are hundreds more who arrive treating their addictions with methadone.

But for those who can’t make bail, staying behind bars has long meant no methadone – the leading medication to ease painful withdrawal symptoms and a proven strategy to keep addicts off of heroin and clear of criminal lifestyles.

Now, that’s changing.

Maryland’s new program to dispense methadone to heroin addicts who are held at the Baltimore jail awaiting ail has rapidly grown into one of the nation’s largest efforts to deliver the addiction treatment behind bars.

The Maryland Department of Public Safety and Correctional Services launched the effort in January and dispensed methadone to nearly 2,800 people by June 30. Only the New York City jail on Rikers Island provides the medication to a greater number, a federal official said.

The vast  majority in Baltimore – 2,478 inmates – received methadone to treat their withdrawal from active heroin addiction. An additional 288 people received it to continue with daily doses they had been getting at methadone clinics before their arrests.

The program is on track to treat about 4,500 addicts by the end of the year. The estimated 7,500 others are released too quickly to obtain the treatment, or they refuse medication.

And correctional officials estimate that the jails will be able to continue methadone for 540 individuals by the end of 2008.

Keeping methadone patients on their medicine while they await trial vastly improves the likelihood that they remain in treatment if they are released on bail or a judge’s ruling, officials said. Officials hope the program will reduce crime linked to drug abuse. “The worst thing we can do is disrupt someone’s treatment while they’re in the middle of care,” said Gregory C. Warren, director for substance abuse treatment services for the corrections department. The program also prevents needless suffering from withdrawal, he said.

Danyelle Wallace has experienced the suffering several times, from withdrawing from heroin and methadone after getting arrested. Vomiting. Backaches. Diarrhea.

But when she was arrested in early June for stealing crab meat from a supermarket, she was surprised to learn bout the methadone program.

“In the past they weren’t medicating anyone and I saw the pain that people was going through trying to detox and kickoff the methadone, which was worse than kicking heroin,” Wallace, 38, said during an interview in jail last month.

“I am really tired of allowing myself to keep coming to prison with a dope habit, trying to kick it. I made a step to get into a methadone program and I don’t want to lose it.”

It took nearly three years to start the program because methadone clinic licenses had to be obtained for four facilities: central booking, the men’s detention center, the women’s jail and the infirmary, Warren said.

Benjamin Brown, Maryland’s deputy commissioner for the division of pretrial detention and services, said the delay was partially due to resistance from an institute whose core duty is incarceration, not treatment.

When convicted and sent to long-term placements, inmates are taken off methadone as a detoxification process.

In nearby jurisdictions, policies vary. In Baltimore County, only methadone patients who are arrested and detained on weekends can get access to their methadone. Anne Arundel Counties detention facility tapers methadone patients off their medication, including detainees who are awaiting trial.

Nick Reuter, a senior public health analyst for the U.S. Substance Abuse and Mental Health Services Administration, said Baltimore and Rikers Island are distinctive.

“What’s unique is giving methadone treatment to individuals who are in that pre-trial phase at all,” Reuter said. “Usually when inmates are at that stage in the criminal justice system, no one is thinking about relieving their opioid withdrawal symptoms. It’s probably the most important time because that’s when the inmate or patient is at the highest level of withdrawal.”

In general there has been opposition to giving out a powerful opiate to prisoners, even though it is a medication administered in a supervised setting.

Before the effort started in January, methadone patients had to stop their medication and would get kicked out of their clinics while jailed. They would also have to use less effective, anti-nausea medications to ease their withdrawal symptoms.

Barry Branch, 45, was jailed in Baltimore last month after testing positive for cocaine use, which was a probation violation.

The driver for AAA Ice on Belair Road is also a former heroin addict who is being treated with methadone. Branch said he did not get his methadone dose right away in jail but it came fast enough to avoid serious withdrawal.

“I’m just glad it’s here,” Branch said. “It’s good you can go back to your program.”

A continuing study by the Friends Research Institute of Baltimore shows that inmates with a history of heroin addiction who are on methadone and engaged in counseling when released are far less likely to commit crimes or relapse on heroin. That impact is proving attractive to officials in a corrections department that has traditionally focused more on punishment.

“The idea that we may play a part to reduce the impact of drugs on the street is a good thing,” said Brown, Maryland’s deputy commissioner of corrections. “We generally don’t get a chance to reduce the bigger problem.”

The new program connects jail officials with methadone clinics to keep patients on their proper doses and to hold their treatment slots if they are released. It requires coordination with more than a dozen clinics and the city’s health department.

“It’s a huge step forward for the jail,” said Baltimore’s health commissioner, Dr. Joshua M. Sharfstein.

Carol Butler, director of service programs for the Institutes for Behavior Research, which operates a mobile methadone clinic, said previously there had been no such communication.

She said addicts are often locked up for nonviolent charges such as late child support payments or delinquent traffic tickets.

“Say you’ve been in treatment and you are making progress, then all of a sudden you’ve been arrested and you can’t make bail,” Butler said “They’ve lost their treatment slot. They’ve lost what they’ve accomplished in the treatment program. This allows them not to lose everything because of their incarceration.”

Upon release, addicts tend to return to heroin and the criminal lifestyles they had largely abandoned, she said.

During each of the five times that Tyrena Dyson had been arrested on drug-related charges, the 36-year-old Baltimore resident said, withdrawal symptoms set in quickly.

“Terrible. Painful,” she recalled.

She was arrested most recently for theft and drug possession and, this time, felt none of it. “I had no withdrawal,” Dyson said during a recent interview at the Baltimore City Detention Center.

Without the continuation of her methadone, Dyson said, she believes she would have returned to heroin after being released. She still struggles with cocaine, which methadone does not treat.

Every time she was arrested and withdrew from methadone or heroin, she got out of jail and went right back to the life of an addict. Dyson, Wallace and Branch all returned to their methadone programs after being released from jail last month.

“I feel like when they made us suffer then we go back out and use,” Dyson said. “By still being on methadone, I can go straight back to my program.”

“So it’s not like I’m starting over.”

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