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$econd Chance: The Economic Case For Drug Treatment Over Jails

Imagine living and working somewhere designed to fit a couple hundred people. Now picture that same space crammed with twice that number. Madison County, Kentucky, Jailer Doug Thomas doesn’t have to imagine it. He lives it.

“I’m doing all that I can with what I have to work with, which is not a lot,” he said. “Because we’re a 184 bed facility with almost 400 people.”

According to the Madison County jail task force, roughly 80 percent of the people incarcerated there are jailed on charges that somehow relate to addiction. County Judge Executive Reagan Taylor wants to try a different approach.

Madison County, Kentucky jailer Doug Thomas.

“It didn’t take long looking at our statistics to realize that we really didn’t have a jail problem, that we had a drug problem,” he said.

Judge Executive Reagan Taylor of Madison County, Kentucky.

Taylor is looking into expanding the current jail for the county just south of Lexington. But he also wants the county to partner with private companies to build what he calls a healing center. People whose charges stem from a substance use disorder would be diverted to the treatment facility instead of going to jail. It’s part of a small but growing trend in the region’s law enforcement agencies to find creative approaches as the Ohio Valley’s opioid crisis pushes jails beyond capacity.

Dollars and Cells

Taylor said a new 800-bed jail would cost his county about $50 million and it would still likely be full in about ten years. He said because so many are in jail for drug related charges, a treatment center seems like a better return on investment.

“We’ve got to spend money one way or the other,” he said. “So do we want to spend money to where we just have to continue spending money and kicking the can down the road, or do we want to spend money to where we have a solution?”

Taylor said the healing center would provide long-term rehabilitation that would help people get back on their feet. Taylor wants it to be more than a basic detox facility. The center would include peer support, life skills, and education or vocational training. Taylor said he wants people to be able to become tax-paying members of their community again.

Madison County’s jail holds nearly 400; it was designed to hold 184.

A Second Chance

Eric Hudnall, of Athens, Ohio, was prescribed opiate painkillers after a car accident left him with a painful neck injury. He became dependent on the pills and soon, a growing addiction and some bad social influences led to his arrest for breaking into a home. That landed him in front of a prosecutor who opted to offer Hudnall a drug treatment facility instead of jail.

Hudnall said that because he was honest and spoke up about his addiction he was given a chance to turn his life around.

“As long as you’re truthful with people you’re going to get help,” he said. “Now, if you hide stuff and you lie to them and they find out about it, they’re not going to trust you and they’re not going to help you.”

Hudnall said he was almost homeless when he entered the treatment program. Now he has a place to live, a steady job and a car.

“If it wasn’t for the prosecutor’s office or Health Recovery Services I’d probably still be addicted to opiates or even in prison,” he said. “Everybody deserves a chance.”

https://www.youtube.com/watch?v=5R84QpVyfy8

There are a lot of people in the criminal justice system like Hudnall who are incarcerated because the need to feed their addiction led them to a crime other than drug possession.

In West Virginia, for example, only 12 percent of the prison inmates were charged with a drug possession charge. But about 43 percent incarcerations in the state’s jails required substance abuse treatment of some kind in 2016.

Economic Appeal

According to the National Institute on Drug Abuse, one year of methadone or medically assisted treatment costs about $4,700. That’s one-fifth of the cost to incarcerate one person in the Ohio Valley for a year — a $25,612 cost on average.

Warren County, Kentucky, Circuit Judge Steve Wilson, who has worked in the legal field for 35 years, said that economic argument is appealing, even for some prosecutors and judges who favor a tough “law and order” approach.

“Truly a tremendous driving force is the fact that economically it’s much better trying to treat people than it is to incarcerate people,” he said. “Because at the end of incarceration without treatment we still have the same problem.”

Wilson said the criminal justice system is often the first chance someone with substance use disorder has at getting treatment. He said prosecutors and judges need to be patient. They may well see the same offender more than once. Although it can be frustrating he said they have to try.

“I’ve always been afraid that once we send somebody off to prison we really have a feeling it’s not our problem anymore. We’re still paying for them,” he said.

ReSource reporters Aaron Payne and Mary Meehan contributed to this report.

Lawmakers Consider Ways to Combat Opioid Epidemic in 2018 Session

The start of the 2018 state Legislative session is only one month away. Lawmakers in the Eastern Panhandle met in Martinsburg for a Legislative Outlook Breakfast hosted by the Berkeley County Chamber of Commerce to discuss several issues they hope to tackle at the statehouse this year.

One focus is creating more ways to combat West Virginia’s opioid epidemic — particularly how the crisis affects those in the state’s foster care system.

The state Department of Health and Human Resources reported in November that nearly 6,400 children are in some type of foster care – whether that’s in traditional foster homes or in other placements like emergency shelters. The West Virginia Children’s Home Society says at least 50 percent of kids in foster care are there due to drug related issues.

Senate Finance Chairman Craig Blair, a Republican from Berkeley County, suggested one way to tackle the problem would be to offer long term, reversible birth control to mothers who are addicted to drugs.

Blair said by providing easy access to things like IUDs, or intrauterine devices – would be more cost effective for the state than spending the hundreds of thousands of dollars spent on special care for children born with drug related issues.

“You get this contraception out there,” Blair said, “You will see a significant reduction in the amount of children being born [with drug related issues] and the money that we have to spend weaning them off whatever their mother was addicted to.”

Blair says he’s pro-life but states he’s pro-contraception as well. He argues this option would be another way to combat the opioid epidemic and help keep more children from being born with drug related ailments.

The 2018 state Legislative session will begin on January 10.

Study Aims to Determine Which Anti-Drug Messages are Most Effective

A team of researchers at Ohio State University is trying to determine what anti-drug messages are most likely to cause potential drug abusers to say no to…

A team of researchers at Ohio State University is trying to determine what anti-drug messages are most likely to cause potential drug abusers to say no to drugs.

28 participants watched 32 30 second PSAs while in an functional magnetic resonance imaging scanner. Half were at high-risk of drug abuse and half were at low-risk. Drug abuse risk was assessed with a self-report measure that the participants had completed earlier.

The researchers looked specifically at connectivity patterns between different parts of the brain while the anti-drug messages played.

Later, the participants rated each PSA on how strong its arguments against drug abuse were.

The study found that low-risk potential drug abusers were able to accurately tell researchers, which messages their brains found most effective while high-risk potential drug abusers were not.

Researchers say the findings point to evidence that people at high-risk for drug abuse are processing anti-drug messages differently than low-risk people.

The study appears in the December 2017 issue of the journal Social Cognitive and Affective Neuroscience.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.

West Virginia Has Record Fatal Meth Overdoses in 2017

State health data shows West Virginia has seen a record number of fatal overdoses from methamphetamine this year, increasing by 500 percent since 2014.

The Charleston Gazette-Mail reports statistics released by the West Virginia Health Statistics Center show about half of the overdoses involved the powerful synthetic opioid fentanyl.

The statistics show 30 residents of Kanawha County have died of meth-related overdoses this year, the highest in the state, followed by 28 deaths in Cabell County. They were followed by Raleigh and Wood counties with eight such deaths apiece.

Appalachian High Intensity Drug Trafficking Area prevention officer Chad Napier says some overdoses occur because meth addicts don’t know they’re consuming fentanyl.

The state Board of Pharmacy has found no overdoses linked to prescription methamphetamine used to treat attention-deficit disorder.

Public Comment for Opioid Response Plan

The West Virginia Department of Health and Human Resources announced Thursday steps for an opioid response plan to combat the opioid epidemic. DHHR is asking West Virginians to help develop the plan through public comment and recommendations over the next 15 days.

DHHR said in a news release, the opioid response plan will be delivered to Governor Jim Justice and the West Virginia Legislature by mid-January.

Until then, however, DHHR’s new Office of Drug Control Policy has opened up a comment period to West Virginians, and is looking for suggestions on the best ways to address the opioid crisis.

The Office will also look to partnerships with regional and national experts as the plan is developed – coordinating with a panel of public health experts from West Virginia University, Marshall University and Johns Hopkins University.

The expert panel will include:

Dr. Sean Allen, Assistant Scientist in the Department of Health, Behavior, and Society at Johns Hopkins University’s Bloomberg School of Public Health. Dr. Allen has advanced training in geospatial and longitudinal data analyses. He formerly served as a senior policy advisor in the White House Office of National Drug Control Policy.

Dr. Jeffrey Coben, Dean of the West Virginia University School of Public Health and Associate Vice President of Health Affairs. He has achieved international recognition for his accomplishments in the field of injury prevention and control.

Dr. Shannon Frattaroli, Associate Professor of Health Policy and Management at Johns Hopkins University. She is one of the lead authors of America’s Opioid Epidemic: From Evidence to Impact, a report released by Johns Hopkins University and the Clinton Foundation.

Jim Johnson, Director of the DHHR’s Office of Drug Control Policy. He has 29 years of law enforcement experience and has served as both a police chief and director of the Mayor’s Office of Drug Control Policy in Huntington.

Dr. Sean Loudin, Associate Professor at the Marshall University Joan C. Edwards School of Medicine. He specializes in neonatal-perinatal medicine with research and clinical interests that have focused on neonatal abstinence syndrome.

Participation of the Johns Hopkins University faculty is made possible with support from the Bloomberg American Health Initiative.

A public meeting will be held following the conclusion of the public comment period to include treatment providers, first responders, law enforcement, and several others.

A release of the draft plan for public comment is expected the first week of January.

Marino Withdraws from Consideration to Lead National Drug Control Policy Office

After national scrutiny, Pennsylvania Representative Tom Marino has withdrawn from consideration to lead the National Drug Control Policy office – a position commonly called the Drug Czar. West Virginia Senator Joe Manchin, who has been vocal about his disapproval of the nomination, applauded the move.

The announcement comes just days after an article was released by The Washington Post and CBS’s “60 Minutes” reporting Marino sponsored a 2016 law that weakened the Drug Enforcement Administration’s authority to stop companies from distributing opioids in already devastated areas.

Senator Manchin told reporters in a press call he would like to see President Donald Trump nominate someone who’s in the medical field and who may have dealt with the epidemic first-hand.

“I would say the perfect person would be somebody that has the passion to fight it and cannot be swayed by all the influence, or all the money, or anything else that has swayed people before from doing their job here,” Manchin said.

President Trump told reporters Monday he would consider withdrawing his nomination, but Marino beat him to the decision.

In a letter to Trump, Manchin called the opioid crisis “the biggest public health crisis since HIV/AIDS.” West Virginia is number one in the nation for most overdose deaths related to opioids.