How mental health and substance abuse treatment help incarcerated Tennesseans | Opinion

Jeremy C. Kourvelas
·3 min read
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One of the most urgent topics in Tennessee right now is criminal justice reform. With 80% of all Tennessee crimes relating to drugs in one way or another, obviously the conversation must include treatment for mental health and substance use disorder.

Fortunately, this seems to be the case. Shortly after Memphis' crimes hit national media, a legislator tweeted, “We need a comprehensive rebuild of the entire criminal justice system. That means more support for mental health and substance abuse.”

Science backs this statement up. According to a meta-analysis of almost 50 studies, opioid-related interventions before, during and after incarceration “decrease opioid-related overdose and mortality, reduce opioid use and other risky behaviors during and after incarceration, and improve retention in addiction treatment after prison release.”

About two-thirds of all incarcerated Tennesseans meet the criteria for a diagnosable substance use disorder. This is a truly substantial population that would benefit from receiving evidence-based treatment, such as medications for opioid use disorder.

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Treatment programs help prevent relapse

As of now, only one jail in the entire state− Jefferson County− offers a program that assesses a person upon intake, initiates a course of treatment and immediately connects that individual to a treatment program outside the jail.  This program was implemented in October 2021.

The Residential Drug Abuse Program is the U.S. Bureau of Prison’s most intensive treatment program. Cognitive Behavioral Therapy is used in a modified therapeutic community model where offenders experience living in a pro-social community. Offenders live in a unit separate from general population; they participate in half-day programming and half-day work, school, or vocational activities. RDAP is typically nine months in duration.

Many people are diverted from the criminal justice system into drug courts, and this does have a tremendous impact. These efforts were bolstered by the recent Alternatives to Incarceration Act, which incentivizes local governments to develop alternatives to incarceration, prohibits the revocation of parole upon one instance of a technical violation and opens drug court eligibility to people that were otherwise ineligible.

Another recent bill, the Reentry Success Act, holds individuals accountable for treatment through supervision programs while shortening time between parole hearings. Both of these bills passed in 2021.

In the meantime, there remain individuals who would significantly benefit from receiving treatment within correctional facilities themselves. Evidence-based treatment for mental health and substance use disorders delivered during incarceration reduces symptoms and disciplinary problems, improves post-release adjustment and decreases recidivism risk.

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Arguably the most dangerous period of time for a person with a substance use disorder involved in the criminal justice system is the first two weeks after they are released back into the community. If the person has not received or continued treatment, they face a strong risk of relapse and potentially fatal overdose.

Sometimes this relapse includes drug-related crimes. Preventing that relapse is the key to keeping Tennesseans alive and out of prison.

The changes to telehealth policy have enabled the treatment program and coordination employed at the rural Jefferson County jail. This is crucial, as the rate of incarceration is increasing the most in rural areas while these facilities tend to have the fewest resources.

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However, this program connects inmates to resources they might otherwise not have, which should reduce their risk of overdose and recidivism. The SMART Initiative is watching this program closely and will be detailing future results.

In the meantime, listen to the latest episode of the SMART Policy Podcast− which features Circuit Court Judge Duane Slone and Dr. Stephen Loyd of Cedar Recovery discussing this program. It's available on all podcast platforms.

Jeremy C. Kourvelas earned his master's in public health from the University of Tennessee Knoxville. He is the Substance Use Program Coordinator, SMART Initiative, Substance Misuse and Addiction Resource for Tennessee at the UT Institute for Public Service.

This article originally appeared on Nashville Tennessean: Mental health and substance abuse treatment help incarcerated people