Jail is the de facto treatment for many struggling with addiction

Newsrooms across the commonwealth have spent years documenting the opioid crisis in their own communities. But now, in the special project State of Emergency: Searching for Solutions to Pennsylvania’s Opioids Crisis, we are marshalling resources to spotlight what Pennsylvanians are doing to try to reverse the soaring number of overdose deaths.

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Jason Wasylenko gave the prison employee his sizes and was handed a pair of jeans and a chambray shirt.

The 32-year-old gathered his belongings — some art made by other inmates, sports posters, a TV and stereo — and left his cell of the last three years.

He filled out paperwork and verified his identity so the guards at State Correctional Institution at Rockview, in Centre County, knew they were releasing the right person. He’d been through it all several times before.

Still, he was anxious.

Jason was accustomed to life behind the wall. He knew what to expect. And he knew what to expect after he was released, too — both good and bad.

“When you go in and you’re putting all your baggage at the curb, when you come out that baggage is still sitting there waiting for you,” he said. “And some people’s bags are a lot heavier or lighter than others.”

For as many as 80 percent of inmates, including Jason, that baggage includes problems with drug use, multiple national studies have shown. But with limited access to treatment on the inside or tools to deal with addiction on the outside, about 95 percent use again once released.

In Bucks County, 245 out of its 815 inmates are in some kind of drug or alcohol treatment program, attending AA or NA meetings, group therapy or other designated programs, correction officials said. Although about 75 percent of the jail population faces addiction issues, not all of them want treatment, and for the majority of them the programs are voluntary.

“They are not beating down the doors to get to this,” said Mike Palumbo, drug and alcohol specialist supervisor at the Bucks County Correctional Facility. The waiting list for the program rarely extends to 10 names.

But demand is growing, especially among those who have never been in a recovery program, Palumbo said.

“Jails often pick up what society doesn’t offer, when society doesn’t offer treatment and then jails get people who aren’t treated,” he said. “We could just give them three meals and keep them safe. But that is how we get a repeat customer. We are trying to find a way to intervene and put in a stopgap.”

In addition to the programs, inmates who are medically cleared and struggle with an opioid addiction are offered Vivitrol, a drug that blocks the effects of alcohol and opioids. Also called naltrexone, the drug is offered along with the HOPE treatment and recovery program, which operates out of a separate area of the prison.

Recently, the state Department of Corrections and Department of Human Services announced a plan to streamline the process for applying for medical assistance for inmates being released from state facilities.

About 10 percent of the 20,000 inmates released from state facilities each year qualify for medical assistance because of chronic medical or mental health diagnoses or substance use disorders, according to the DOC, but the process of applying “has proven both labor intensive and time consuming.”

“It is in the community’s best interest to have those that leave succeed,” Corrections Secretary John Wetzel said. “Ensuring they have access to medical and mental health benefits is essential to a successful transition back to the community.”

Providing treatment in jails and prisons has been found to reduce recidivism rates in national studies, but the things that improve the outcomes for inmates are the same as for the general population, said Ken Martz, special projects consultant for Gaudenzia Inc., who has worked with prisons in Maryland and Pennsylvania.

“Study after study, decade after decade, the No. 1 predictor of outcome is length of treatment,” said Martz, who also served for several years as special assistant to the secretary of the state Department of Drug and Alcohol Programs.

“Treatment occurs in the context of a relationship,” Martz said. “Where I begin to know that I can trust you and can begin to share the secrets of my shame and trauma, my abuse history. That, I’m not going to do on day one.”

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