How a small county jail runs a large-scale addiction program for inmates
They are doing something different inside the Benton County Jail. Inmates here line up to take a crushed pill that could break a cycle of drug addiction and may prevent them from returning to jail over and over again.
More jails across the country have begun treating inmates with opiate addictions with the hope of reducing recidivism rates. But many haven’t seen success like Benton County has.
“I’ve spent most my life in and out of prison due to drugs,” says 60-year-old Richard Thomas.
He blames sticky fingers; a propensity to steal things to support his heroin habit as a big problem.
“I needed to make sure there was money set aside for drugs before there was food,” Thomas said.
He is one of more than 1,000 men and women just this year who have, and still are, participating in a medically-assisted treatment (MAT) program inside the jail located in Kennewick, Washington.
But unlike other MAT programs at other jails, Benton County has something called a "warm handoff."
“He looked right at me as said he was dying,” said Benton County Sheriff Jerry Hatcher of an inmate and heroin user who was brought into the jail nearly three years ago.
He was undersheriff at the time and in charge of running the jail.
“That gentleman died an hour later,” Hatcher recalled. “I’ll never forget it. It rocked me to my core and I felt as a sheriff I had to find a different way to do this."
The University of Washington produced a report in 2018 about opioid use disorder in Washington state jails. It states that over half of the regular illicit users of opioids in Washington will pass through a jail in the same year.
Jails have started distributing Buprenorphine to opiate users as a form of treatment. The life-saving drug reduces cravings for heroin. It’s become one of the most effective drugs to treat opioid addicts, but it takes a commitment to stay on it.
Hatcher felt he needed to do more than just hand out Burprenorphine to his inmates.
“I started thinking about 'What if I went out and found one of these MAT doctors and got them to actually come in,'” Hatcher said.
At a conference, he met Jeffrey Allgaier, the founder and chief medical officer of Ideal Option, a drug addiction treatment organization headquarter in the Tri-Cities.
Using what he had in his budget and grants from Washington State Opioid Response, Benton County’s MAT program now includes doctors and medical staff inside the jail. They counsel inmates, as well as prescribe, and learn about the issues they face.
“It’s very rare, they took a big risk to do the right thing for patients despite allot of opposition,” Allgaier said.
Patients KOMO spoke with say the care they are getting has made a big difference.
“They never made me feel like I am homeless,” Thomas said. “He says, 'How are you doing with the cravings?' I said, 'Doc there’s no cravings.' I was just amazed.”
The warm hand off
But the real success is what is referred to as the "warm hand off." It takes place after the patient leaves the jail and it's when the difference is made. The same doctors and medical staff that the patients see inside the jail, are the same ones they see outside at an Ideal Option clinic.
“All of the doctors I've seen at the jail, I’ve seen here at the office,” Ariona Monson said while making one her regular visits to the clinic.
Staff has been known to pick up a former inmate as soon as they are discharged from the jail and take them directly to their first appointment.
“When I was in jail, my person told me, 'You know you've been in here so many times and you are going to be here for a little bit. Why don't you try something that is a little different?'” Monson recalled. “So I did.”
“It’s either jail , treatment, or you are going to end up dead” she said. “I did it to get my kids back.”
She’s now in her seventh month of sobriety from heroin.
Of the jails receiving Washington State Opioid Response grants, the participation rate at Benton County Jail is three times more than the combined numbers from four other jails receiving grants. In the first eight months of 2019, 56% are still enrolled in the program after leaving the jail.
“The evidence says this should absolutely be done widely across the United States, in every jail and prison,” Allgaier said.
The commitment by Ideal Option has been personal as well.
“My brother actually died of a heroin overdose,” said Carrie Mahler, the nurse manager inside the jail who distributes and meets with all the patients.
“So when I was asked to actually to do this program, it was like such an honor,” Mahler said. “I never got to say goodbye to my brother, but I can help people today.”
