Doing rehab in jail differently for heroin addicts in the USA

I’ve taking care of thousands of people struggle with addiction and I’ve had hundreds. By okay, I don’t even keep track anymore so you got to make good choices and that’s what they teaching us here. I don’t think there’s anything more difficult to do than sit through funerals for 22 or 21 year old kids.

America is in the midst of an opioid epidemic that shows no sign of slowing down.

Neighbors say they called 911 overdosed couple early Sunday morning the startling sight that greeted a West Side Milwaukee woman in March on a public bus outside of Philadelphia. I’m in the town of Greenfield Massachusetts nestled between mountains and valleys this town of 17,000 is picturesque and quaint but like many communities it has been gripped by the opioid epidemic but they’ve taken some innovative approaches to help fix this problem and it all starts at their local jail.

Tell me about what opioids have done to this community  – opioids came into our community and started killing young people and I think that was the greatest impact that had on me personally and why I devoted myself for forming this taskforce to try to educate young people tostay away from this and to try to treat the people who had already been sucked in by it. You have an interesting term that you refer to the jail as it’s not just a jail or a luxury facility when did you start calling about when we had gentlemen going to court in front of a

judge and saying don’t sentence me to 30 days judge sentenced me to six months because I need that kind of treatment at the Franklin County House of Corrections that’s what I know.  We were a lock treatment facility.  This facility holds 225 incarcerated people 90% of those incarcerated here have a diagnosed substance use disorder or mental disorder.

I’m gonna meet an individual whose house here right now who has struggled with substance use disorder in the past including opioid use. He’s gonna tell us a story it’s gone alright how’s it gone how are you nice to meet you?

Is this the kind of common area right here yeah yeah this is where we live here’s saw 71 of us I believe double bunk cells I’m in a single cell there I live in cell 20 there’s 36 cells I’m an artist I do art I do tattoos now what led you to be here I’ve got a year here for a violation of probation got some other matters that are still in court and I’ve done a lot of time I’ve done about 16 years on Aldrin and I’m 40 now I’ll be 40 in two weeks so almost half of your life yeah almost half of my life here now I’m adding to the gels mindfulness-based therapy session which is intended to help people deal with all the issues surrounding substance abuse allow yourself to kind of move to get yourself into that kind of neutral position in your mind’s eye I want you to pull out a picture and in this

picture is someone you adore.

what role did drugs play in all this get started

with percocets you know it just

progressed you know from percocets into

heroin at the time that I started doing

heroin I was homeless I was living in

the woods and the first time I did it

was like you know all of that stress and

all of that frustration and anger that I

had towards my life that like kind of

went away Mike would you like to start

what showed up for you as we went

through this exercise I started I

started with a really good memory and I

went to him

you know something I don’t care about

missed that got paid for a little bit so

the first part you noticed regarding

someone you care deeply with all your

heart and then you also notice that

feelings emotions came along with that

as well you respond to this as if it’s

real so the greater capacity we have to

see the mind for what it is to see

emotions for what they are they’re not

asked as part of who we are and to

commit to those things that we do know

move us in value directions it’s not

terribly complicated it’s just tricky to

do on a dated moment-to-moment basis and

that’s why we practice right it’s been

such an evolution in the conversation

around the country regarding the opioid

epidemic how has this community

distinguished itself you’ve got to do

things you otherwise would never do

because this is different than anything

we’ve ever experienced before

so I’ll point to one example we started

doing suboxone here at the jail you go

to any correctional facility in the

country suboxone is their number one

contraband why would you give us about

some why would you give some of these

drugs that do the same thing that heroin

might do we’re not creating a group of

people that are out there hi we’re

creating a dosage amount that allows you

to live with your cravings and function

productively that’s the goal and you

will be in treatment you will be under

supervision but most importantly we’re

removing you from the criminal behavior

equation I had some of this they brought

this into the kitchen and they served it

with us at lunch do you remember what

it’s called yeah I don’t remember what

it’s called yeah I remember it was

pretty it’s got a spice to it okay did

you guys try this

you try that it has a bit of a kick does

anyone remember I didn’t get the name of

it and told of the gardening program

yeah the gardening program is really

cool it kind of gets you down into the

earth a little bit you can get out there

and you can smell the plants when you

get connected to those plants that makes

you more conscious – that’s and that’s

what I’m saying it’s like there’s a

consciousness going on

and that is a scallion yeah it’s a good

onion shoot yeah that’s pretty good

pretty good

we’re so used to doing the same things

that it’s really hard to change that

behavior so it’s really cool that

they’re integrating a few different

things for us to do that are outside of

maybe our typical comfort zones you know

I mean and that helps you change

behaviors which is abord am I thinking

is maturing on average we have about a

hundred units of dopamine and people who

struggle with addiction wake up in the

morning and they wake up with a dopamine

level of 40 or 45 they’re irritable they

are having physiologic withdrawal and

they feel miserable and their brain is

screaming at them you know how to make

this better you know how to make this

better go get it fixed right when it

comes to training these cadets why is

that important the average person

doesn’t understand what addiction does

to the brain I don’t expect them to like

they why would they know that so when

they learn about what it is that they’re

the people that get arrested go through

I actually think it builds for them a

sense of empathy and understanding and

of knowledge that it can allow them to

actually provide better care for them to

know what what is kind of a fundamental

thing that everybody needs to understand

about opioid addiction it breaks the

brain in a very specific way and it

breaks the reward circuit of the brain

the part of the brain that tells you to

live or die and it’s a disruption of the

neurotransmitters in the brain and it

has very specific behaviors compulsion

and perseveration I have to do this and

I cannot stop thinking about this and

it’s a frustrating disease to treat and

you may get mad at your kid you get may

get mad at your niece but I’m telling

you their brain is telling them that in

to use the drug we take care of people

who struggle with addiction and our job

quite honestly is to make them better

can you explain and characterize where

Greenfield and where this region is at

right now in terms of the opioid

epidemic so we’re we’re sitting in the

most rural county in Massachusetts

Franklin County I don’t think the

problem here is any worse than it is

anywhere else the truth is I travel all

around the country the problem was

terrible everywhere

in 2017 Franklin County saw a 60

reduction in overdose deaths compared to

the year before but this year the region

is experiencing an uptick in deaths due

to the increased presence of fentanyl

and street drugs reflecting the ongoing

struggle in this epidemic I’m gonna meet

a man named Sean who runs a farm and who

houses people who are in recovery right

now we’re just getting started we have

three residents who live here now

they all have chores that take place on

the farm whether it’s feeding the goats

or the pigs or whatever we have and what

do you think it is about opioids that

have such a grip on people and take such

a toll I can only say for my personal

experience I will say that I craved

drugs on a cellular level no different

than the instinct to breathe that’s what

it felt like to me to want to use so

that’s what we’re up against

yeah I think I want to walk with baby

goats everywhere I go now yeah whether

they’re like the greatest dogs you’ll

ever meet

we have a cafe under construction where

we’ll be serving the products that we

produce here from seed to sandwich it’ll

be worked by someone who’s in recovery

and has a need for employment you know

so this is the back-breaking labor that

we do here we’re gonna feed these baby

goats they’re about two and a half

months old as you can see they they love

their warm milk I suffered a work

accident back in 2014 and was prescribed

heavy narcotics predominantly percocet

heavy percocet for that my whole life

fell apart after that you’re depending

on a drug becoming somebody who I think

you never thought you’d become it’s

heartbreaking when someone’s working

maybe sense of purpose through the day

the chances of mistakes over the ones

are increased tremendously I’ve learned

through being here what it’s like to

care for another life I came out here to

get away from the environment that I was

in and this place kind of saved my life

I have some goals and instead of like

being manic and trying to manipulate my

way towards those goals I’m just trying

to relax

you just live you know I believe

everybody should have a chance to have a

full life ahead of them and that young

people dying in the medical world

ignoring it is unacceptable my hope for

this community is that we get through

this that we continue to be stronger

because of it and making sure that the

next generation doesn’t have to deal with this.