Addicted Inmates to Receive Treatment, But It Might Be Hard to Sustain After Release

Aug 5, 2015

Chris Rocket has been in prison for 19 years. His convictions are for second degree murder and robbery. The crimes, he says, were the result of an alcohol addiction.

His addiction to heroin and prescription drugs?

He got hooked on those while incarcerated at the state prison in Berlin.

“Somebody would just offer it to me and I would mostly say yes,” Rocket says in a phone interview from the prison. “It's so prevalent on a daily basis you can find it. It’s always around no matter where you are.”

Rocket just graduated from a substance abuse treatment unit at the Berlin prison, where his treatment consisted of group therapy several days a week.

But Helen Hanks, assistant commissioner at the Department of Corrections, says the DOC will soon begin treating recovering addicts with a prescription medication that could prevent relapse after they are released. 

“We're targeting the use of naltrexone as a very positive intervention for people especially who are addicted to heroin and other opiates,” Hanks says.

Sidebar: The Science on Naltrexone

Click to expand this statistic.

 Naltrexone is one of three medication-assisted treatments for opioid addiction. Unlike methadone and buprenorphine, naltrexone is not a controlled substance; it's non-addictive and it won't get you high.

It works by blocking the euphoric effects of opioids.  

Dominic Donahue is clinical director at Serenity Place, a drug treatment center in Manchester. He says medication-assisted treatments like naltrexone could help offenders beat their addictions.

“It’s so effective,” Donahue says. “I think it’s crucial.”

Offenders in this program will have access to prescribers and existing support services like case management and behavioral therapy inside prison. Studies show drugs like naltrexone work best alongside that wraparound care.

The problem is that those treatments can be hard to come by on the outside.

Click to expand this statistic.

State health officials report the wait for adult individual or group therapy is as long as 28 days, and up to three months for inpatient treatment. 

Donahue says that could make it harder for parolees trying to stay clean.

"You cannot do medically managed care, i.e. Suboxone, methadone, naltrexone - whatever that medication is - and not have behavioral health treatment,” he says. “It has to go hand in hand.”

And, while Medicaid expansion now covers substance abuse treatment for most parolees, that could change if lawmakers don’t reauthorize the program. Without that coverage, many will find it hard to pay for medication and therapy.

"We can do the best job in the world in prison trying to get somebody straight,” says DOC Commissioner Bill Wrenn. “But when they leave to go back to the community it's like walking off a cliff.”

Half of the inmates in the U.S. have a substance-abuse problem, according to the Department of Justice. And in N.H., almost 60 percent of parolees who land back in prison within three years do so because of drug-related crimes.

Jack Wozmak is the state’s appointed drug czar. The DOC’s naltrexone program is one of 22 recommendations he's made to Gov. Maggie Hassan to address New Hampshire’s growing opioid crisis. 

Wozmak acknowledges that the shortage of treatment on the outside could be a problem for parolees. But that doesn’t mean they shouldn’t have access to it while on the inside.

“Some things will move ahead faster than others,” he says. “There’s no perfect start to this, because while an orchestra might start up all on the same cue because they’re ready, all of the instruments of treatment are not there yet, they’re not ready. “

Click to expand this statistic.

Several states, including Massachusetts, Rhode Island and Vermont, use an injectable version naltrexone in local jails and prisons that has been found to be more effective.

That drug, called Vivitrol, would cost the DOC $1,200 a month for each patient. Instead, New Hampshire is going with the pill form, which is $18 a month.

With about 5 years left to go behind bars in Berlin, Chris Rocket is preparing for life on the outside. When he's released, he wants to stay sober.

“I don’t wanna come back,” he says. “And if I get out there and I’m actively using I don’t think there’s any way I can stay outside of here.”

Rocket says the naltrexone program is "good thing" and he's interested in participating when the Department of Corrections introduces it this fall.