LOUISVILLE, KY – Louisville Metro Government has announced that it has been selected to participate in a national program to expand medication assisted treatment (MAT) for opioid use disorder in jails.
The Planning Initiative to Build Bridges Between Jail and Community-Based Treatment for Opioid Use Disorder (OUD) program will provide expert guidance on how to overcome barriers to providing opioid treatment, including staff training and guidance for jail officials in creating treatment guidelines, managing administration of the medications, and educating jail staff about addiction.
Louisville Metro is one of 15 jurisdictions that will participate in the program, which 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.
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.
Locally, the Louisville Metro Department of Corrections has become, by sheer necessity, one of the region’s largest mental health and substance abuse treatment and detox facilities. And in partnership with others, LMDC has already initiated some MAT programs.
In 2016, for example, LMDC launched the Pathway Advocacy and Alliances for Community Treatment (PA2CT) Program, which provides Vivitrol treatment for individuals suffering from OUD returning to the community. With funding provided through the Kentucky State Department of Corrections, the program provides Hepatic Function Panel labs, drug screens and Vivitrol injections for any individual volunteering to start MAT while in LMDC custody as part of their discharge plan. The voluntary MAT program is coordinated with LMDC medical services provider, Wellpath.
In 2017, LMDC, in partnership with Wellpath and the Department of Public Health and Wellness’ MORE Center, began providing high-quality MAT to incarcerated pregnant women. Previously, opiate-dependent women receiving methadone had to be transported off site on a daily basis to receive treatment. Now, a certified alcohol and drug counselor from the MORE Center comes on site to administer the needed medication and complete routine evaluations. This initiative saved the LMDC an average of 126 off-site trips per month in the last quarter of 2018. Methadone is considered the gold standard of care for pregnant women with opioid addiction by reducing the risk of obstetrical and fetal complications, in utero growth retardation, and neonatal morbidity. To date, the program has been successful and has resulted in effective treatment of 3 pregnant women in 2017 and 34 pregnant women in 2018. In total, 21 percent of pregnant women have continued treatment at the MORE Center following release from LMDC.
“Expanding access to treatment is one of our goals in our citywide plan to reduce substance use disorder,” said Dr. Lori Caloia, medical director for the Louisville Metro Department of Public Health and Wellness. “Medication assisted treatment is evidence based. It works. It can help people with the disease of Substance Use Disorder rebuild their lives and reduce the likelihood of them engaging with the criminal justice system again.”
Faith Augustine, director of the Louisville Metro Criminal Justice Commission, said the commission will work with the local departments of Corrections and Public Health and Wellness to implement this new program.
“We look forward to working with the local team and serving as the administrative and operational coordinator to guide the planning effort,” she said.
LMDC Director Mark Bolton noted that the nationwide opioid crisis has led the jail to triple the number of residential substance abuse treatment beds, as it works on initiatives to manage those at risk while in custody.
“The next logical step is to expand treatment for opiate use disorder for individuals who remain in custody,” he said. “We have the commitment to help this population and now with support of our federal, state and local justice partners, we will have additional resources to help people confined in the jail more effectively combat substance use.”
Kelli Rhee, president and chief executive officer of Arnold Ventures, said of the program: “We could change the trajectory of the opioid crisis by treating people in jails. Our goal is to create a model for local leaders who want to tackle this problem head on.”
“Sheriffs, Correctional Officers and jail administrators are key beneficiaries when treatment is provided in jails and continued in the community. Not only does this lessen the burden of drug-related crime, but it stops the revolving door of individuals with opioid use disorder that enter our jails every year and present a potential danger to law enforcement and themselves,” said Jon Adler, Bureau of Justice Assistance Director.
For more information about the Planning Initiative to Build Bridges Between Jail and Community-Based Treatment for Opioid Use Disorder, visit https://www.arnoldventures.org
FULL LIST OF SELECTED SITES
Camden County, NJ
Chesterfield County, VA
Clackamas County, OR
Cook County, IL
Cumberland County, ME
Durham County, NC
Eaton County, MI
Hudson County, NJ
Ingham County, MI
Jefferson County, KY
Lewis and Clark County, MT
Marion County, IN
Orleans, St. Bernard, Plaquemines Parishes, LA
Shelby County, TN
St. Louis County, MN