VALPARAISO — As the release date nears for inmates in the Indiana Department of Correction, those with substance abuse problems are at an increased risk of going back to using drugs and/or alcohol no matter how long they have been sober, according to the director of addiction recovery services.
This is the case because the anticipation of regaining access to drugs and/or alcohol is enough to fuel dangerous cravings in addicts, Stephanie Spoolstra said.
Prison officials have a tool that has proven effective in not only combating cravings, but also literally standing in the way of opioids and alcohol producing euphoric effects on users. And a small, but growing, number of counties around the state are taking notice, including Porter County.
The tool is the drug Naltrexone and Porter County Sheriff Dave Reynolds intends to begin offering it July 1 to qualified inmates leaving the jail if the county's judges sign off on the program as expected this coming week.
Injection and pill forms
Reynolds said he and a team of others involved in the local legal system are attempting to derail the troubling pattern of substance abusers being released from jail only to victimize the county once again.
"Then what are we doing?" he asked. "They eventually will just be coming back."
The proposal calls for administering the drug by injection a day or two before the inmate is released on a voluntary basis, Reynolds said. This form of the drug remains effective for up to 30 days, he said.
Continued use of the drug, in conjunction with addiction treatment, will then be required as part of the offender's probation or pretrial release, he said.
The IDOC provides its injections of the drug seven days prior to releasing inmates, who qualify through a screening process and medical review, Spoolstra said.
The effort has proven effective enough that it is now being expanded to include a pill form of the medication that will be provided to inmates 90 days before their release to combat cravings, she said. It will also be offered to incoming inmates to combat their cravings.
"We're starting to use it as a maintenance medication," Spoolstra said.
The medication has no known time limits on use and has minimal side effects other than to cause a painful detox for those who have used drugs up to 10 days earlier, she said.
Neither Lake nor LaPorte counties currently uses or is pursuing use of the drug Naltrexone, according to their sheriff's departments.
Therapy and 12 step included
To understand how Naltrexone works, Spoolstra suggested seeing opioids and alcohol as keys that fit into a lock and open a door. Naltrexone is also a key that fits into the same lock, but does not open the door and blocks the opioid and alcohol keys from entering.
Naltrexone, which goes by the name Vivitrol in injectable form and Revia as a pill, is most effective when used in conjunction with a therapeutic and 12-step recovery program, she said.
Reynolds said inmates released on the drug will face violating their probation or pre-trial release if they fail to follow through with treatment.
The drug is different than other medical treatments for addiction such as Methadone and Suboxone in that it does not have a mind-altering impact on users, Spoolstra said. This means it is not abusable and thus more appropriate for an institutional setting like a prison.
Police said earlier this year they had broken up a highly coordinated effort of smuggling Suboxone into the Porter County Jail in the form of tiny sublingual sheets that were sold for up to $100 each among inmates.
Officials at the IDOC's Westville Correctional Facility said they caught a mother earlier this year attempting to smuggle Suboxone into the prison for her son.
No cost to taxpayers
Reynolds said he was approached a couple years ago with the idea of using Naltrexone at the jail.
"The reason we didn't was the cost," he said.
The injection costs between $500 and $1,700 per dose, depending where in the country it is purchased, Spoolstra said. The pills cost $1 each.
Porter County will not be spending any tax money on the effort, Reynolds said. The cost of the medication will be charged to the offender's insurance or Medicaid coverage, he said. It can also be billed to the state's Recovery Works program, which provides support services to felons without insurance coverage.
The IDOC also relies on insurance, Medicaid and Recovery Works to cover the cost of the drug once the inmates are released, Spoolstra said.
The drug maker donates the injectable form for use within the prisons, she said, and the prison's medical provider covers the in-house use of the pills.
Both the state and county programs are completely voluntary. Reynolds said it will be up to defense attorneys to request participation for their clients.