Jail first in state to provide in-house methadone treatment
By Douglas Hook
MassLive.com
GREENFIELD, Mass. (AP) — Allan J. Ryan has spent the past decade in-and-out of trouble with the authorities. His longtime struggles with drug addiction led him to present-day life inside the Franklin County House of Correction in Greenfield serving time for larceny.
In the library of the jail, he sits. A tall, slender man in an orange jumpsuit, he waits for his dose of methadone daily. He looks over the top of his oval glasses waiting for the nurse to call his name so he can walk over and relieve his craving for the heroin addiction he has developed over the years.
One by one, inmates stand up from the row of 15 chairs to receive their morning dose of buprenorphine or methadone.
Methadone has been a saving grace for Ryan because he says that it creates a feeling of satisfaction that enables him to function without the cravings coming back during the day.
“It’s the first time in years that I really want to stop,” said Ryan. “It’s changing my way of thinking.”
In addition to medication, Ryan and others in the treatment program also attend counseling and behavioral therapy with the hope that they can break habits that led them back to drugs when they are released.
The Western Massachusetts jail is the first in Massachusetts to provide in-house methadone treatment to combat the ongoing opioid crisis.
The sheriff’s office received federal and state approval to establish the state’s first and only jail-based licensed methadone clinic. A total of seven county jails offer methadone assisted treatment to inmates addicted to drugs.
Essex, Hampden, Hampshire, Middlesex, Norfolk and Suffolk county jails are using private companies that bring the drug in from another location. Franklin is unique in that it has its own in-house clinic.
“I refer to our House of Correction as a locked treatment facility,” said Franklin County Sheriff Chris Donelan. “This Opioid Treatment Program designation closes the circle for us on the full range of treatment options we can offer to offenders who find themselves in the criminal justice system because of addiction.”
Before the clinic was certified, inmates would be driven over 80 miles roundtrip daily to get medication.
Of the 15 clients in the library awaiting their medication, three have been prescribed methadone with the rest taking buprenorphine.
“The actual medication is inexpensive: about $2.70 per dose for buprenorphine,” said Assistant Deputy Superintendent for the Franklin County Sheriff’s Office Ed Hayes. “And methadone is much less than that.”
Buprenorphine, sold under the brand name Subutex, helps diminish cravings and withdrawal symptoms of opioids. Methadone also reduces opioid cravings and withdrawal symptoms. It also blunts or altogether blocks the effects of opioids. Both are commonly used medications to assist in recovery from heroin and other opioids.
Over the years, Ryan worked odd jobs to fuel his addiction. He estimates spending an average of $60 a day on his habit.
The money needed to buy the narcotic couldn’t be made through the work he was doing according to Ryan and eventually, he turned to crime.
His most recent crime and the reason he is now incarcerated was on charges of stealing a woman’s bag at a laundromat in Franklin County. The purse had $7,000 in cash that she had just withdrawn, according to court records.
“I saw her counting it in the bank,” said Ryan.
One officer said in their report that after reviewing security camera footage, they knew Ryan’s face well for other offenses that he had been involved in the community. He was arrested the same day and sent to Franklin County Sheriff’s House of Corrections to await trial.
Ryan’s story is like so many others that come through the doors of the jail.
“This has been one of the most challenging projects in my 20 years as a physician,” said Medical Director of the Franklin County Sheriff’s Office Dr. Ruth Potee. “My hope is that we have paved the way for other correctional facilities to provide treatment for those struggling with this disease. Methadone has been a proven treatment for nearly 50 years. We need to reduce the barriers to access.”
“I was a heavy user,” said Ryan. “I have a problem when my drug use gets out of control, I commit larceny.”
Ryan said before he was arrested he was using at least six grams of heroin and a gram of cocaine each day.
As he awaits his daily dose of methadone he sits in silence in the library of the house of corrections, staring at the floor in front of him.
The opioid-related death rate in Massachusetts has surpassed the national average. According to the Massachusetts Department of Public Health, there was an average of almost six opioid-related overdose deaths per day in 2017.
There were 1,913 drug overdose deaths involving opioids in Massachusetts in 2017 - 28 deaths per 100,000 people - twice as high as the national rate of 14 deaths per 100,000 people.
“This public health crisis has hit Massachusetts particularly hard,” ACLU said in an open letter regarding medication-assisted treatment in jails. “Opioid-use disorder is especially dangerous for people who are or have been incarcerated.”
Ryan started using when he was 15, shortly after his parents died of cancer within a few months of each other.
He first was introduced to narcotics at 17 years old, first smoking marijuana then using cocaine. After a while, Ryan wanted a “deeper,” heavier high and looked to heroin for that fix.
He went on a drug-fueled spending spree at 18 when he gained access to the $250,000 inheritance his parents left. Within a year, he had nothing left.
“I was a free soul,” said Ryan. “I need structure.”
Structure is something the House of Corrections does well.
Correction Case Officer Jenise Rivera greeted Ryan and others when they arrived at the jail and assists clients with the start of their detox program.
Once a new client arrives at the jail, blood tests are done to see what drugs they may have in their system and from that, as well as interviews, correction officers and medical staff create a plan that will work to wean them off drugs.
“One month ago, he came back to the jail,” said Rivera. “He’s very respectful, a role model inmate.”
Rivera was assigned Ryan when he came to the jail and advised that he would be an ideal candidate for the methadone treatment.
“This is a person that was using methadone on the outside,” said Rivera.
The National Sheriffs Association estimates that at least half to two-thirds of today’s jail population has a drug abuse or dependence problem. Some counties say the percentage is even higher.
On the outside are his two young daughters who he religiously calls every Friday for 15 minutes. The short phone call costs him $9.50.
“My daughter told me she’s had enough being in-and-out of my life,” said Ryan.
Ryan is optimistic about the future and says that once he has finished his time in jail, he looks forward to seeing his daughters again. With the help of the clinic, he is now more than ever, determined to leave his addiction behind.
“It saved my life,” said Ryan.
