Anoka County piloting innovative treatment of jail inmates on heroin

In a first-of-its kind program in Minnesota, heroin-addicted Anoka County jail inmates will be offered a prescription drug that lessens their cravings in hopes of focusing on their recovery once they're released.

The program announced Thursday, allows inmates to voluntarily take an injection of the drug Vivitrol, which is given every 30 days at no cost as long as they remain in jail. Before an inmate's release, the county arranges a treatment plan to deal with mental and substance issues with a network of social workers and clinics.

Until the program was developed, the jail had few options available to ease withdrawal symptoms. That usually led to a quick return to heroin use, crime and landing back in jail, said County Sheriff James Stuart.

"I see this as an investment to stop the revolving door," he said. "And a chance to become the person they were created to be."

Vivitrol, which costs as much as $1,000 per shot, has steadily gained acceptance as an effective treatment for opioid dependence since it was approved by the U.S. Food and Drug Administration in 2010. Alkermes, the drug's maker, is providing the first dose for the county program at no cost.

The drug will be provided to inmates after they are screened and detoxed. The county's jail medical budget will cover the costs if more than one shot is needed.

When inmates are released, they are placed in a 24-week outpatient treatment program, followed by another 24 weeks of support group work. They are responsible for the cost of additional Vivitrol injections, if needed, but the drug is eligible for insurance coverage or state assistance.

Post-jail treatment is being coordinated through the county's correctional health services and Nystrom & Associates, which owns 11 treatment sites throughout the state. The business agreed to pick up the tab for support group sessions.

"This is not a 'dose and you go' treatment," said Brian Nystrom, the company's president.

On Thursday, Hennepin County Sheriff Rich Stanek said they will monitor the success of Anoka's program before considering it for their jail. Currently, inmates with heroin issues are watched and treated under an intensive supervision protocol. The state's Department of Corrections offers medication-assisted treatment, but not Vivitrol.

State prisons in Kentucky, Missouri, Utah, Pennsylvania, Tennessee, Colorado and West Virginia now offer Vivitrol. Roughly 30 jails in Illinois, Michigan, Missouri, Maryland, New York, Ohio, Utah, Indiana, Wyoming, Kentucky, California and Wisconsin do as well.

The National Institute on Drug Abuse sponsored a study of about 300 offenders who were randomly assigned to receive either Vivitrol or brief counseling and referral to a treatment program.

After six months, the Vivitrol group had a lower rate of relapse — 43 percent compared with 64 percent. A year after treatment stopped, there had been no overdoses in the Vivitrol group and seven overdoses, including three deaths, in the other group. When the injections stopped, many in the study relapsed. A year later, relapse rates looked the same in the two groups.

Alkermes defended the results of Vivitrol, which has gained momentum with prison and jail officials in the last several years, said Matthew Henson, the company's public relations director. The drug gives local and state governments an opportunity to treat inmates with opioid addictions and reduce jail overcrowding and recidivism, he said.

"The status quo isn't working, and this isn't a silver bullet," he said. "But everyone is being aggressive and creative to treat and get this population into recovery and save lives."

Cody Wiberg, executive director of the Minnesota Board of Pharmacy, meets monthly with an opioid task force. A frequent topic of discussion is the need for a comprehensive approach to tackle the drug epidemic. Although he couldn't speculate on the impact Vivitrol would have on inmate recovery, any potential prevention and treatment has to be applauded, he said.

Stuart agreed. Last year, Anoka County had a record number 17 opioid deaths.

"There is always a risk when you try something new," he said. "But this program has minimal risk. We wouldn't we make this change?"

David Chanen • 612-673-4465