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Addiction Treatment Behind Bars

November 6, 2019

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Terry Carl didn’t like what he saw. Addiction was spreading rampantly through his native Northern Kentucky, bringing death and destruction with it. As the Kenton County jailer, he teamed up with Addiction Services Director Jason Merrick to do something about it.

Instead of sending people off to treatment, they brought  treatment to the jail. The Kenton County Detention Center’s Comprehensive Opioid Response with 12 Steps Jail Substance Abuse Program (COR-12 JSAP) promised to keep addiction from sapping the lives of inmates.

“It had the clients and it had the beds, so it just made good treatment sense to implement programs at the jail,” Merrick says. “A brick and mortar inpatient treatment facility costs millions, maybe even tens of millions of dollars to build, and we already have that. We have the beds, we have the food—it’s a state-of-the-art facility and everyone is here being taken care of. All we had to do was plug in these social services. It was a no-brainer and an easy fit. The entire jail staff is determined to change the way we view and respond to addiction.”

COR-12 JSAP works closely with circuit and district court judges to determine eligibility. A typical participant is in custody for at least 90 days (for stabilization, to get used to medication); gets out of jail (instead of going on to serve a prison sentence); and their probation is contingent on aftercare and remaining committed when the going gets tough.

Initially, 70 of the center’s 600 beds were allocated for the program. The program continued to grow and now, 150 beds are dedicated to substance use disorder treatment.

COR-12 JSAP includes a diverse array of therapies as well as educational, life skills training, and 12 step programs. MAT is used in conjunction with cognitive and behavioral therapy for detoxification, stabilization, and maintenance. Services are also specialized for pregnant women. In 2018, they partnered with the Hazelden Betty Ford Foundation to expand services.

When participants with opioid use disorder have completed 30 days of therapeutic programming, they can volunteer to receive injectable naltrexone or buprenorphine. Participants are connected with a clinician pre-release who helps them with Medicaid enrollment and connects them with an appropriate community provider to ensure continuity of treatment.

COR-12 JSAP has funding for 200 clients per year. So far, some 260 have gone into aftercare.

“We forget what the meaning of corrections is,” Merrick says. “We want to take this time to help our clients while incarcerated. Each of our clients wouldn’t have had this opportunity if it weren’t for incarceration. There’s life, there’s bills, there’s kids. When you walk into the treatment dorm, you feel an immense sense of gratitude.”

He tells the story of a young man who came through with a long history of substance misuse. “You could see the progression in his mug shots; his cheeks grew sunken, there was weight loss, blemishes, and sores. The third time he went through the program, it stuck. He became a different person, someone I’d never met before. He got out and is working out and put the weight back on. Now he’s working part-time and going to school. He comes back to the jail to share his experience of strength and hope with other clients. Human life is delicate. We need to use all the resources available to protect it.”

“We hope this kind of program can be a catalyst,” Sanders concludes. “With the right partners, this can be implemented anywhere regardless of size and funding.” With SAP, they have witnessed hundreds of lives repaired, strengthened, and renewed. 

Kenton County Detention Center Comprehensive Opioid Response with 12 Steps Jail Substance Abuse Program was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.

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Mark Powell

J. Mark Powell is an author, former network journalist, and veteran communications expert. Read more about Mark Powell.