This Groundbreaking Letter From Dozens of Sheriffs and DAs Calls for MAT in Jails

6 months

Lack of access to methadone and burprenorphine, lifesaving opioid use disorder medications, for vulnerable incarcerated populations has long been a stain on the US criminal justice system.

On April 3, a groundbreaking open letter—signed by 58 current or former elected sheriffs, district attorneys and other law enforcement and criminal justice officials and leaders from across the US—called for this situation to end in jails and prisons, and for naloxone distribution on release.

Incarcerated populations are hugely important in the context of addressing the opioid-involved overdose crisis. A 2018 CDC report indicated that in around 10 percent of overdose deaths, there was evidence of the person being released from an institutional setting in the month prior.

Law enforcement voices have the potential to be powerful influences on mainstream and government opinion. The letter was organized by Fair and Just Prosecution and the Law Enforcement Action Partnership (LEAP)*, two pro-reform advocacy groups.

“For too long we have tried to punish people into abstaining from drugs rather than expanding access to strategies that work,” said Miriam Krinsky, executive director of Fair and Just Prosecution. “Requiring people to be cut off from medically assisted treatment while in custody flies in the face of proven best practices and increases fatal overdoses when people reenter the community. It’s time for a different way forward.”

“Society demands that [jails] also serve as a hospital, mental health institution, school and rehabilitation center,” said Richard Van Wickler, Superintendent of the Cheshire County Department of Corrections in New Hampshire and a speaker for LEAP. “Providing adequate and responsible healthcare to treat addiction through medication-assisted treatment is a requirement, not an option.”

“A prosecutor’s role does not end at the prison door,” said signatory Sarah George, Chittenden County State’s Attorney. “We are obligated to use our voices to ensure in those instances when people absolutely must be incarcerated, they leave custody in a position to safely reenter their communities.”

As Filter has reported, a few encouraging signs of increased MAT availability for incarcerated people have emerged in recent months—with a federal judge in Massachusetts ruling in favor of a defendant receiving methadone, and a pilot program for injectable burprenorphine announced by Pennsylvania’s Department of Corrections. It is to be hoped that the new letter will increase this momentum.

Here is the full text of the letter, which attorney and Filter contributor Rory Fleming played a role in drafting, with the full list of signatories below:

As current and former elected local sheriffs and current elected prosecutors, as well as other law enforcement professionals, we are committed to protecting public safety and the safety of individuals in our custody. We believe that providing medication-assisted treatment (MAT) like methadone and buprenorphine in jails and prisons, as well as ensuring that individuals released from custody have naloxone and a continuing care plan, is part of that duty.

Medical research shows that many people who are unable to stop illegally using opioids through abstinence-based treatment are able to stop when using methadone or buprenorphine as a part of medication-assisted treatment (MAT). While abstinence-based heroin treatment has a 5 to 15 percent long-term success rate, MAT program success rates exceed 50 percent. In addition, most people relapse at least once before they successfully enter recovery. People on MAT are much less likely to die of an overdose if they relapse.

Decades of studies show that MAT use decreases illicit drug use, crime, and health costs to communities. Continuing MAT care in county jails and prisons is essential to ensuring that formerly incarcerated people do not relapse and reoffend upon release.

Forcing people in jail to detox is difficult and dangerous. Withdrawal brings vomiting, diarrhea, and low blood pressure. People can die from dehydration while detoxing in jail—and a number have.

Those forced to detox in jail or prison are also more likely to die from overdose upon release. According to a report last August by CDC researchers on overdose deaths, “Approximately one in 10 decedents had evidence of having been released from an institutional setting in the month preceding the fatal overdose . . . [T]he most common settings being jail, prison, or detention facilities when only illicit opioids were involved (4.9%). . . These data suggest a need . . . to expand treatment in detention facilities and upon release.” Fortunately, research shows that providing MAT in correctional facilities reduces the risk of overdose death post-release by 85 percent.

In order to reduce overdose and improve recovery success, we also believe in ensuring that individuals struggling with addiction should be provided with naloxone and a continuing care plan upon release.

We recognize that this epidemic of drug overdose requires a new approach. Over 70,000 Americans died from drug overdose in 2017, more than have ever died in a single year from the epidemics of crack cocaine, H.I.V., car crashes, or gun violence.

We will work within our own jurisdictions to respond effectively to the new realities of the opioid crisis. By doing so, we will avoid needless fatalities, reduce the use of illicit opioids, and improve safety in our communities.

Respectfully,

Craig Apple
Sheriff, Albany County, New York

Branville Bard
Commissioner, Cambridge Police Department, Massachusetts

Sherry Boston
District Attorney, DeKalb County, Georgia

Patrick J. Cahillane
Sheriff, Hampshire County, Massachusetts

John T. Chisholm
District Attorney, Milwaukee County, Wisconsin

Jerry L. Clayton
Sheriff, Washtenaw County, Michigan

Brendan Cox
Former Chief, Albany Police Department, New York

John Creuzot
District Attorney, Dallas County, Texas

Satana Deberry
District Attorney, Durham County, North Carolina

Christopher J. Donelan
Sheriff, Franklin County, Massachusetts

Thomas J. Donovan, Jr.
Attorney General, Vermont

Michael Dougherty
District Attorney, 20th Judicial District, Colorado

Jay Fleming
Former Deputy Sheriff, Park County, Montana

Wendell France, Sr.
Former Deputy Secretary, Department of Public Safety and Correctional Services, Maryland

Kimberly Gardner
Circuit Attorney, City of St. Louis, Missouri

Sarah George
State’s Attorney, Chittenden County, Vermont

Sim Gill
District Attorney, Salt Lake County, Utah

Ed Gonzalez
Sheriff, Harris County, Texas

Mark Gonzalez
District Attorney, Nueces County, Texas

Christian Gossett
District Attorney, Winnebago County, Wisconsin

Andrea Harrington
District Attorney, Berkshire County, Massachusetts

Patrick Heintz
Former Corrections Officer, Hampden County Sheriff’s Department, Massachusetts

Pete Holmes
City Attorney, Seattle, Washington

Martin Horn
Former Commissioner, Department of Corrections, Pennsylvania

John Hummel
District Attorney, Deschutes County, Oregon

Kathleen Jennings
Attorney General, Delaware

Lawrence S. Krasner
District Attorney, Philadelphia, Pennsylvania

Karl A. Leonard
Sheriff, Chesterfield County, Virginia

Chris Magnus
Chief, Tucson Police Department, Arizona

James Manfre
Former Sheriff, Flagler County, Florida

Beth McCann
District Attorney, Second Judicial District, Colorado

Brian Middleton
District Attorney, Fort Bend County, Texas

Nick Morrow
Former Detective and Deputy Sheriff, Los Angeles County Sheriff’s Department, California

Marilyn J. Mosby
State’s Attorney, Baltimore City, Maryland

Peter Neronha
Attorney General, Rhode Island

Michael J. Neustrom
Former Sheriff, Lafayette Parish, Louisiana

John Padgett
Former Sergeant, Richmond County Sheriff’s Department, Georgia

David Parrish
Former Jail Director, Hillsborough County Sheriff’s Office, Florida

Joe Pelle
Sheriff, Boulder County, Colorado

Karl A. Racine
Attorney General, District of Columbia

Sue Rahr
Former Sheriff, King County, Washington

Carrie Roberts
Former Corrections Officer, Department of Corrections, Colorado; Former Deputy Sheriff, Arapahoe County Sheriff’s Department, Colorado

Rachael Rollins
District Attorney, Suffolk County, Massachusetts

Marian T. Ryan
District Attorney, Middlesex County, Massachusetts

Dan Satterberg
Prosecuting Attorney, King County, Washington

Carol A. Siemon
Prosecuting Attorney, Ingham County, Michigan

Mark Spawn
Former Chief, Fulton Police Department, New York

Norm Stamper
Former Chief, Seattle Police Department, Washington

Richard W. Stanek
Former Sheriff, Hennepin County, Minnesota

David E. Sullivan
District Attorney, Northwestern District, Massachusetts

Tom Synan
Chief, Newtown Police Department, Ohio

J. Scott Thomson
Chief, Camden County Police Department, New Jersey

Pete Tutmark
Former Deputy Sheriff, Clackamas County Sheriff’s Department, Oregon

Richard N. Van Wickler
Superintendent, Cheshire County Department of Corrections, New Hampshire

Cyrus R. Vance, Jr.
District Attorney, New York County, New York

Peter Volkmann
Chief, Chatham Police Department, New York

Andrew H. Warren
State Attorney, 13th Judicial Circuit, Florida

Scott Wriggelsworth
Sheriff, Ingham County, Michigan


*LEAP is the fiscal sponsor of The Influence Foundation, which operates Filter.

Photo by Matthew Ansley on Unsplash

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