Sheriff’s Opioid Addiction Treatment Program is Nationally Recognized
By Colin A. Young
STATE HOUSE NEWS SERVICE
BOSTON -- A drug addiction treatment program run out of the Middlesex Sheriff’s office earned national accolades this week as one of a handful of programs across the country leading the way on providing medication-assisted treatment in jails.
Sheriff Peter Koutoujian said the success his three-year-old program shows that medication-assisted treatment (MAT) is a useful tool in combatting opioid addiction as inmates prepare to re-enter society and bodes well for a recently-approved pilot program for expanded MAT in jails.
“We knew that it’s not only important to save lives and save families and communities for those participating, but if we could create something that would work and ... it was something that could be replicated outside Middlesex County, that could save that many more lives and families,” Koutoujian said Thursday. “I’m so pleased with the fact that our program and four others across this nation will be seen by more and hopefully be replicated by many more.”
Koutoujian’s Medication-Assisted Treatment and Directed Opioid Recovery (MATADOR) was recognized by the National Sheriffs’ Association and the National Commission on Correctional Health Care as one of five national “best practices.”
Launched in 2015, the MATADOR program begins with medically-managed withdrawal for participating inmates and then shifts to treatment and casework services provided by officers and program staff. As part of the program, participating inmates are educated on the different forms of MAT.
Prior to release, a participating inmate is given an injection of Vivitrol, the brand name for naltrexone which helps prevent relapse, and is put in touch with a navigator or recovery coach who schedules follow-up medical and treatment visits.
Koutoujian said the support the navigators provide after an inmate has left the sheriff’s department custody is key to the program’s success.
“We can’t set them up for medication-assisted treatment and expect great success unless we provide them with extra supports,” he said, adding that his office now has more than 100 partners across the state. “That’s the use of the navigators or recovery coaches, people on the outside who stay in contact with them and monitor their success so we can have good data and provide the supports they need to be successful.”
Koutoujian said 412 people have participated in the MATADOR program. A risk assessment tool found that had they not participated in the program the likelihood of recidivism for those 412 people was 90 percent, the sheriff said.
But of all 412 participants, just 23 percent had another conviction or parole violation after participating in MATADOR, he said. And of the 370 inmates who completed the MATADOR program, 81 percent had not been re-arrested for new crimes as of January 2018.
Word of the program’s success has spread through the jail populations, Koutoujian said, and now a majority of the participants come to the program having heard about it from another inmate.
“Consistently for the last few years, 80 to 90 percent, and some months were 100 percent, were individuals who were self-referred, meaning they heard about the program and wanted to try it,” Koutoujian said. “They might have had an opioid problem and they hadn’t had a good life on the outside and many have tried the agonist therapies methadone and suboxone and they want to try something new that might give them a chance at being successful in their recovery.”
The opioid addiction treatment law signed by Gov. Charlie Baker in August calls for correctional facilities in Hampden, Hampshire, Middlesex, Norfolk and Franklin counties to run a three-year MAT pilot program beginning September 2019. Like Koutoujian, some other Bay State sheriffs already offer MAT using Vivitrol, but the pilot will make more inmates eligible and will make more medications available as forms of treatment.
“Our experience in developing and then making adjustments in our MATADOR program is really going to be helpful,” Koutoujian said. He added, “We are going to have the most ambitious program in the entire country and it will be the most watched program in the entire country.”