High rate of KY inmates face drug charges. Do jailers see better way to handle drug use?

For Madison County Detention Center Jailer Steve Tussey, the drug epidemic is “absolutely a health care issue.”

But about 80% of his inmates at the Madison County jail are facing drug-related charges, and are contributing to a recidivism rate of 60%. Other jails in Kentucky are housing more than half their inmates on drug charges too. Some Kentucky jailers are showing concern that repeatedly housing those charged with drug possession, rather than treating their drug use, is only making drug problems worse.

“It began as a choice and a drug issue, but once they are hooked, it is a health care issue,” Tussey said. “They have a sickness and we need to treat that sickness. The brain is now telling them to do drugs just like our brain tells us to eat.”

The detention center Tussey oversees in Richmond has implemented programming which helps individuals experiencing substance use disorder. And Madison County isn’t the only facility trying to offer help to those incarcerated on drug charges.

Jailers: Offering programming helps lower recidivism

Tussey said the detention center’s programming for substance use disorder falls under the umbrella of a grant from the University of Kentucky HEALing Communities Study, a four-year, $87 million study that began in 2019 aimed at reducing opioid overdose deaths by 40%.

HEAL has provided overdose education and naloxone (NARCAN) to people on community supervision. The study has also provided resources to connect people on medication for opioid use disorder with a certified peer support specialist.

The jail has used the money from the study to hire a peer support specialist through the Voices of Hope program. The program helps inmates with substance use disorder by issuing medication for opioid use disorder, providing harm reduction education and guiding people to financial assistance when they leave jail.

“Something else that our peer counselor does is meeting with inmates prior to release and giving them resources they need to find jobs, get interviews, family planning – which can help make an inmate successful and not come back to jail,” Tussey said.

According to Alex Elswick, co-founder of Voices for Hope, one of the components of the HEALing Communities Study is the Justice Community Opioid Innovation Network. One of the aims of the network is to increase initiation and maintenance of medication.

“The coaches we hire at Voices of Hope under (the Justice Community Opioid Innovation Network) are mostly formerly incarcerated people in recovery that help connect individuals with resources to support maintenance on (medications for opioid use disorder),” said Elswick, who’s also a professor and extension specialist for substance use prevention and recovery.

With money from the study’s grant, the jail is able to provide access to medication for opioid use to those who qualify, which Tussey said is about 10% of the jail’s more than 400 inmates.

He said inmates can be provided medication for detox purposes, or for prolonged opioid counter measures with Suboxone or Vivitrol.

The peer support coordinator works with a third-party medical contractor, Western Health, who helps conduct an individualized medical assessment, Tussey said.

The Madison County Detention Center is one of the few jails which are part of the pilot program and receive money for it. However, he feels even without the money, programs which administer medications for opioid use disorder would be easy to implement throughout the state.

“The funding helps us treat more people because this peer counselor that is on sight is meeting with inmates daily and helps get with all the people who need help,” he said.

But Tussey said local jails are not designed for programming, although they do as much as they can.

“The whole philosophy of a local jail is a short-term holding facility for the court system. We are here so the police have a place to take people they arrest, and we work with the court while they work to adjudicate,” he said. “A typical stay is 20 days at the jail, so it is really hard to program someone who is not there but three weeks.”

Jennifer Hancock, CEO and president of Volunteers of America Mid-States who works directly with those incarcerated and in recovery, agreed that treatment for substance use disorder in institutional settings is not the most effective.

While she supports programming within jails, she said a longer term solution is to focus on decriminalizing drug use, and diverting those with behavioral health problems from incarceration.

“That environment is not conducive to treating the root of the issue,” she said. “The gateway to substance use disorder is trauma, and the walls of an institution are not a place to treat that going forward. When you peel the onion back, (trauma) is often at the core, and we aren’t treating the core but just the surface.

“Substance use is really just a symptom, and if we want to address the core we have to keep peeling that back.”

‘We need to help them recover’

Brian Wofford, jailer at the Boyle County Detention Center, said the jail should be a starting point for getting treatment.

The Boyle County Detention Center has several programs to help those with substance use disorder recover, and reenter society.
The Boyle County Detention Center has several programs to help those with substance use disorder recover, and reenter society.

His jail is part of the Substance Abuse Treatment Program with the state. The jail also provides other programming through the Shepherd’s House, a recovery center.

Around 75% of those incarcerated in Boyle County are facing drug-related charges, Wofford estimated.

“While they are here, they can start it, and we can provide linkage to a service and they come in and meet with these folks and assess them and work with them to get them treatment for when they are released,” Wofford said. “If they follow through on the plan, they will stay out of jail so they can get treatment.”

He has 40 inmates participating in the treatment program, which has participants go through a six-month, three-phase course to learn about drugs, alcohol and their effects.

Another program offered is called PORTALS New Directions, which helps inmates develop a plan for when they leave jail to organize transportation, employment, jobs and budgeting skills.

Inmates at the Boyle County Detention Center work through the PORTALS New Direction program, which helps them develop a plan to reenter society after incarceration.
Inmates at the Boyle County Detention Center work through the PORTALS New Direction program, which helps them develop a plan to reenter society after incarceration.

“Basically when they walk out they have a plan to be successful,” he said.

Wofford said his facility does provide medicine for opioid use disorder to pregnant women, and Vivitrol to state inmates who qualify.

If someone is booked who is already receiving medication treatment, he said they could continue, but it is determined by medical personnel if they should be able to continue that treatment.

Wofford said that just housing people with substance use disorders is not working.

“It was not working 150 years ago, and it’s not working today,” he said. “They need treatment inside the jail because they are here and instead of just sitting here doing time, they need treatment that can benefit them.”

He said the overall view of how people think of those who are incarcerated needs to change.

“They still have value; they are someone’s mom, dad, sister, brother, people still care about them,” he said. “We need to help them recover and provide services for them to change.”