Vice News report (below) on how in-prison drug programs are working at the NH State Prison for Men in Berlin:
“Cold Turkey: New Hampshire’s Prison Detox”
GOFFSTOWN, NH — Valley Street Jail Superintendent David Dionne says in his 31 years working at the county jail, he thought he’d seen it all.
But things have gotten worse in the past three years.
On Friday he came before the county’s Executive Legislative Committee to bear witness to the crushing weight of the current addiction crisis on the prison system, and offer a possible fix.
After the meeting, Dionne went into some detail about the state of things.
“This morning I had 34 inmates on detox watches. Six years ago, I might have had a maximum of three inmates on detox at any given time,” Dionne says.
“I could show you photographs, people with open sores from infections. Last week I had two inmates who requested furloughs, to attend the funerals of their fiances,” Dionne says. “I’ve said to my command staff that it’s only a matter of time before someone will die of an overdose in our facility.”
Dionne recounted an experience with a recent incoming inmate who had concealed two syringes loaded with heroin in his rectum, discovered during the intake process.
“We don’t do cavity searches, but we do have the inmates squat and cough, which relaxes the rectal muscles. That’s when we saw the syringes protruding from his anus,” Dionne says.
“We need to do something. I see it now. For a long time I was not on board with an idea like this. But I’m here today because I truly believe we have a responsibility to do something to help reverse this trend. Why not while we have them already as a captive audience?” Dione says.
In the state’s most recent 2010 Justice Reinvestment Study, police chiefs and sheriffs from New Hampshire point to insufficient substance use and mental health treatment services as one major contributing factor to rising crime statistics.
And it is also what elevates safety risks for police officers and other first-responders in the field.
On March 4 Dionne presented a proposal to the executive committee representing Hillsborough County’s lawmakers that would bring a program into his jail, one he believes will help reverse the trend of recidivism among inmates — currently estimated conservatively at between 60-70 percent.
He said it will also save lives.
The proposal has the support of the Board County Commissioners, Toni Pappas, Sandra Ziehm and Carol Holden, and Hillsborough County Attorney Dennis Hogan.
Known as Substance Abuse Treatment Community for Offenders (SATCO), the proposed program is not new, or innovative. It’s modeled after programs currently in place in four other New Hampshire Counties — Merrimack, Rockingham, Strafford and Sullivan, which is being looked at as a national model.
On Friday, Dionne asked the executive committee to approve funding the program at Valley Street, which would cost $350,000 annually and require the creation of five related positions — a case manager; a Lead Alcohol Drug Abuse Counselor (LADC), 2 Licensed Alcohol and Drug Abuse Counselor (LADAC) clinicians; and one job development specialist.
Dionne said the intensive 60-day rolling enrollment program could accommodate 40 inmates at a time, or up to 240 annually, male and female, who would be recommended by the court to participate.
Part of the “transitioning process” includes keeping the participants “on watch” for four more months after their release from jail through the use of monitoring bracelets, to make sure they are continuing to check in for meetings and making progress.
There would be a work-release aspect to the program, and the job development specialist would assist inmates find housing and employment opportunities upon release, common roadblocks, which could greatly reduce the risk of re-entry into the prison system. The early release component would also allow health insurance benefits normally suspended during incarceration, to be restored, Dionne said.
“They are incarcerated anyway, so there’s no added cost — only the added cost of personnel,” Dionne told the lawmakers. “It’s a great opportunity for us to treat everybody in the facility, and everybody in the county has the opportunity to get into the program from a judge’s recommendation.”
An existing empty unit at Valley Street would serve as the in-house program site, where inmates would be segregated.
Dionne said with the recent addition of community recovery centers like Hope for New Hampshire Recovery and existing ones like the Farnum Center, there is greater potential than ever for success due to the kind of support, post-release, inmates and others in recovery from addiction desperately need.
Getting inmates started on a path to recovery while incarcerated can help reduce the numbers of people on waiting lists, a percentage of which may inevitably end up in jail before they get to the top of the list and into treatment, Dionne said.
After making a case for how the program would work, and could provide rehabilitation to many of those for whom Valley Street Jail is a revolving door of incarceration on drug-related charges, the committee had a chance to respond.
The first comment came from vice chair Rep. Donald LeBrun, R-Nashua, who was not impressed.
“I sympathize with everything you’re saying, but I believe we tend to want to throw money at the wrong part of our society, the part of our society that is not compliant, and probably never will be compliant,” LeBrun said. “Instead of putting it toward the people who really need it, and that’s in the people who are mentally disabled, the mentally ill and the homeless. They’re people that are compliant with society, and who we should be helping.”
Dionne told LeBrun that those who end up in and out of the county jail are not all bad people, “they’re people who’ve made mistakes, who don’t have family to bail them out. Then they’re stuck here,” Dionne said.
“This number, these 425 people who died from heroin? Nobody even knows if they were touched at all by the criminal justice system; 425 people didn’t die in jail. They died in the streets. There just aren’t any programs for them to go to. The state has a revenue source, the Alcohol Fund, of which 5 percent [of net sales] is supposed to go toward treatment and programs. You haven’t fully funded that for years. The state failed those people,” Dionne said.
“We can agree to disagree,” LeBrun said.
⇒RELATED STORY: Where did NH’s funding for drug and alcohol treatment go?
Rep. Kermit Williams, D-Wilton, responded by saying he had an opportunity to spend a recent shift at Valley Street Jail, where he observed inmates from all walks of life.
“Without a doubt Valley Street Jail is the front line in the war on this heroin crisis. Representative LeBrun, I can tell you there are mentally ill people there because they are unable to fit into society, they are there because they self-medicate with these same drugs that are killing all these other people,” Williams said. “I’d say 80 percent of people in jail at any given time have some sort of drug problem.”
Rep. Robert Rowe, R-Amherst, said a 60-day program seemed inadequate, based on what he has heard about the length of time needed to recover from an opioid addiction, which he said can be more like 2½ years.
Rep. Neal Kurk, R-Weare, said he needed more information to make an informed decision, and moved that a committee be formed to further study programs from other parts of the country that might be better, and to learn more about their success rates.
He also raised concerns about the burden of medical costs and asked Dionne what happens if the expanded Medicaid program is not extended.
“I don’t know,” Dionne said.
“Because that’s the source of your medical insurance, these are able-bodied men and women between 18 and 64 who qualify for expanded Medicaid if it’s expanded by the state,” Kurk said. “And then in the community for the next four or five years, you expect them to get treatment, and that would also be paid for by expanded Medicaid.”
“Some people have their own insurance. I’ve got to tell you that when I say some people have their own insurance, times are changing. These aren’t just drug addicts on the street,” Dionne said.
“These people are important people now who are addicted to opiates. You’re talking about people who are well known people that have a drug problem. And when I say that, if you want to go to the methadone clinic and the suboxone clinic, go at 5:30 or at six in the morning and you’ll see the Cadillacs and the Lincolns, the Lexus pulling up,” Dionne said. ‘They’re all there to get their doses of their pain medication — that’s doctors and lawyers and professionals, who get there early in the morning so people can’t see them.”
Kurk said it sounded to him like any other program out there, and without some assurance that the $350,000 spent would net calculable results, he remained skeptical of the proposal.
“Like Representative LeBrun, I don’t want to spend money just because it makes me feel good to know that I think I’m helping somebody. When I’m spending someone else’s money, I want to know how many benefits they’re getting for each dollar of their taxes that we extracted from them,” Kurk said.
Dionne pointed to statistics he included with the presentation from the state’s four other counties, and that more information is readily available on the program’s effectiveness in other county prison settings.
Rep. Mary Heath, D-Manchester, said she was grateful for the proposal. She said she has watched too many people, including children of friends and neighbors, and former students, “who are good people” who’ve lost their lives, or they’ve ended up in the county system with no treatment.
“The decline in my city due to this horrible problem is horrendous, and my question to you superintendent, is simple: What is the cost if we don’t do this?” asked Heath.
“The cost would be the devastation of more lives being lost,” Dionne said.
Rep. Pat Long, D-Manchester, said he would reluctantly support a study committee, even though he felt it was unnecessary, if it helped others to get on board. He also reminded the committee that they have already heard reports and presentations, including from Superior Court Chief Justice Tina Nadeau, on the efficacy of the programs currently in use in other county prisons.
“A lot of these questions have been answered already, at the State House and at the county level,” Long said.
Heath said she could not support the study committee, noting that much time and research had already been invested by Dionne and others at the county level to present us “with a first step to doing something.”
“I feel we have a responsibility to do something,” Heath said. “Year after year we sit here and we have not taken one step. I think we bear a responsibility to the voters to try and do something. We have time to explore. The superintendent is here at every single meeting and he can report back to us on the progress of the program,” Heath said. “Right now, a person who is arrested and put into the county system gets absolutely no special treatment for drug and alcohol addiction. When are we going to take action?”
After some further discussion, the committee voted 13-6 in favor of Kurk’s motion to form a study committee, which will report back at the April Executive Committee meeting. Committee members are Rep. Neal Kurk, as chairman; Rep. Williams; Rep. Jordan Ulery, R-Hudson; Rep. Suzanne Harvey, D-Nashua; and Rep. Dick Marston, R-Manchester.
⇒Click here to contact members of the Legislative Executive Committee.
⇒Click here for more information: Justice Reinvestment in New Hampshire Analyses & Policy Options to Reduce Spending on Corrections & Increase Public Safety (2010)
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