Markey, Koutoujian push for ‘game-changer’ opioid treatment in jails

Sheriff Peter Koutoujian and Sen. Edward Markey speak about opioid treatment at the Middlesex County. House of Correction

BILLERICA — Addiction treatment needs to be expanded for those in jail or prison, “a population that doesn’t get much attention,” a U.S. senator and local sheriff said on Wednesday

“This is a population that has needs,” Middlesex Sheriff Peter Koutoujian said, flanked by U.S. Sen. Edward Markey at Middlesex County House of Corrections and Jail on Wednesday. “This is a population that we can help, quite honestly.”

About 80% of inmates have a documented substance abuse disorder when they arrive at the Middlesex County House of Corrections, Koutoujian went on to explain.

“And correctional facilities like the Middlesex Sheriff’s Office, we can provide that help to help them right their lives, get themselves on track, rejoin their families and rejoin their communities,” he said.

In 2018, there were 1,976 confirmed opioid-related overdose deaths in Massachusetts, according to the state Department of Public Health. This is a slight decrease from 2,100 confirmed deaths in 2016. In 2010, there were 560 confirmed opioid-related overdose deaths, according to the state data.

The opioid-related overdose death rate of formerly incarcerated individuals is 120 times higher than that of all other adults, according to a 2017 study published by the Department of Public Health.

In 2015, Koutoujian led the Middlesex Sheriff’s Office to launch the Medication-assisted Treatment and Directed Opioid Recovery (MATADOR) program, which helps inmates avoid relapse and related criminal activity after release.

Through the MATADOR program, inmates can receive counseling and training while in prison, and if desired, an injection of Vivitrol, a brand of the drug naltrexone which helps prevent relapse, upon release. The program also guides former inmates to recovery support after release.

Just 13% of those active in the MATADOR program have recidivated, Koutoujian said, while their likelihood of recidivating is 90%. The National Sheriffs’ Association and the National Commission on Correctional Health Care named the MATADOR program one of five national “best practices” in 2018.

“They (former inmates in the program) are inspired, they’re hopeful, they’re strong with their families right now and more importantly, they’re alive,” Koutoujian said.

“I came here today to see a model program for the whole country,” Markey said as he took the podium.

In June, Markey and U.S. Sen. Lisa Murkowski, R-Alaska, introduced the Community Re-entry through Addiction Treatment Enhancement (CREATE) Opportunities Act, which would create a new grant program in the Department of Justice for state and local governments to provide MAT in correctional facilities.

“We’re making treatment the priority. We’re making assistance the priority,” Markey said.

The proposed bill would allow the Attorney General, with the help of an established Medication-assisted Treatment Corrections and Community Re-entry Application Review panel, to disperse four-year grants to correctional facilities to expand MAT options.

Grant recipients would be required to provide more than one MAT option to inmates suffering opioid addiction, and create a plan for guiding inmates to further treatment upon release.

“This is not a Democrat and Republican issue,” Koutoujian said. “This should be bipartisan.”

In a pilot program beginning in September, the Middlesex jail will be able to provide MAT to inmates while in prison, including agonists such as suboxone and methodone.

“Whichever is the MAT that works for you, that is the MAT you should get,” Koutoujian said.

Koutoujian said security measures will be taken to limit diversion of drugs such as suboxone within the facility.

“The benefits that come from a comprehensive treatment program far outweigh the diversion risk,” Markey said.

“This is a game-changer. What’s happening here in Middlesex County actually changes the lives of these people. It gives them hope. It gives them a place and a program that they can rely upon to give them the treatment now, and then the help afterwards,” Markey said.