The Centers for Disease Control and Prevention lists Kentucky among the three states with the highest rates of death due to drug overdose.
While there’s no easy answer, officials who run a Northern Kentucky jail believe they have a program that could be part of the solution, using medication-assisted treatment.
Up on the side of a hill sits the Kenton County Detention Center. Outside, the landscape is beautiful and the building looks sleek. Inside, the jail is overcrowded.
More than 700 men and women are locked up here.
25–year-old Tevin is wide-eyed. Tattoos on his arms name two of his five kids. He looks like a kid himself. He wears a black beard and mustache that cover his baby face. He recalls one of the many times he’s been in jail.
Tevin: “I was incarcerated for possession of a controlled substance. I was using heroin. It was the worst time of my life. I would never want to go back to that again. I was poor, broke, homeless.”
But Tevin is back in jail. He says he was drinking, taking drugs and had anger issues . He doesn’t want to share his last name or why he’s here because of his pending case. But this time instead of “doing his time” with the general population, he’s one of 125 inmates volunteering for an evidence-based substance abuse program.
Every morning he’s up early participating in a very structured routine. It includes classes, reflection and affirmation, meditation, counseling and 12-step meetings.
Tevin : “It’s making me notice things about myself that I didn’t think I could notice. It’s calmed me down a lot, I was kind of stubborn and arrogant about myself. I didn’t care what anybody had to stay. The stuff that we read about it really tells you about the human mind and addictive thinking and criminal thinking.”
Jail Substance Abuse Programs aren’t a new concept, says director Jason Merrick. According to the state’s Department of Corrections, there are more than two dozen evidence-based substance abuse programs in Kentucky jails.
Merrick: “We’ve realized long ago it’s difficult to arrest our way through this epidemic.”
Merrick was hired in 2015 to run the Kenton County Detention Center’s program. He’s been sober since 2009 and spent some time incarcerated. Now he has a Masters Degree. He knows firsthand, it may not be easy but sobriety and healing are possible.
Merrick: “Biologically we recognize the addiction as a disease, psychologically we treat behaviors and thinking patterns. So cognitive- behavioral therapy is a big part of our program. We give people an opportunity to change their behaviors. We give them resources. We give them opportunities to re- enter society better than they were when they became incarcerated.”
In addition to the classes, structured schedule and support groups, the program now includes a medication-assisted component. When the inmates are ready to leave jail they’re offered a shot of Vivitrol if they are medically appropriate.
The drug blocks effects of opiates for a month and helps reduce cravings. The Vivitrol program is completely voluntary and in some circles controversial.
Terry Carl: “It was obvious we needed something to help these inmates. Because they were leaving here and overdosing and the majority of ‘em were dying.”
Terry Carl has held the elected office of jailer for 19 years. At a time when the opioid epidemic is a national crisis, he believes the program at Kenton County Detention Center is making a difference.
Carl: “We’re only treating a small group out of the population, but out of that small group 70% which I think is great, it’s not coming back to jail.”
A 2016 study done by Kentucky Department of Corrections and the University of Kentucky Center on Drug and Alcohol Research says 71% of inmates in the program have not returned within a year after being released and 58% have stayed off drugs.
That’s compared to 74 percent of the jail’s general population who end up back behind bars.
While the study is one measure of success, Kevin Pangburn director of substance abuse services for the Kentucky Department of Corrections points out recidivism is a complex, multi-layered problem, affected by
Pangburn: Family structure,their educational background, their socioeconomic make-up,mental health and other issues.
Still Kenton County Detention Center is one of four jails in Kentucky using the substance abuse program in conjunction with the medically-assisted treatment. The others are Fayette County,Louisville Metro and Pulaski County. Pangburn is proud Kentucky is at the forefront of creating a protocol for this model. Some other states like Rhode Island and Massachusetts have similar programs.
Pangburn: “Until recently there’s been nothing inherently corrective about corrections and that’s not the case anymore. The Bureau of Justice has defined us as a center for innovation. Other states have been sent here to train on what it is we do to follow our protocol. Not to mention the safe hand-off to the community once they’re released.”
Meanwhile inmate Tevin admits to having some fear about getting out of jail but he’s hopeful this time he won’t be back.
Tevin: “Hopefully I can go home and be the dad I always wanted to be. That’s the future for me. I just want to be a good dad”
When the inmates are released, there’s help available like sober living houses and outpatient care, including help to continue the Vivitrol.
The Kenton County medically-assisted treatment program is always evolving and may not be perfect but those who administer i believe it’s a start in addressing the opioid epidemic