Law professor spoke on the opioid epidemic to sheriffs

Western Michigan University Cooley Law School Professor Lauren Rousseau presented information on the opioid epidemic and its implications during the recent Michigan Sheriffs' Association's annual professional development conference in Traverse City. During the conference, Rousseau led a breakout session for over 50 jail administrators representing county jails from around the state. She also moderated a panel discussion with jail administrators from four counties-Oakland, Eaton, Lapeer, and Kent-that are implementing innovative programs for opioid-addicted inmates.

"I was very grateful for the opportunity to educate jail administrators about the opioid epidemic and its implications for our county jails," said Rousseau. "For the most part, opioid-addicted inmates are given no addiction treatment while they are in jail. They are forced to detox off opioids, with little to no medication to ease withdrawal symptoms, and in most cases, have only an inmate-led support group to assist their recovery."

Rousseau noted that the typical length of incarceration in a county jail is two weeks to one month - enough time for inmates to fully detox off their drugs, but not enough time for any meaningful addiction treatment. The inmates' tolerance to opioid drugs drop while they are in jail, and given the lack of treatment, they inevitably seek out their drug of choice upon release. Because their tolerance to opioids has diminished, they frequently overdose in the weeks following release from jail.

"There are studies indicating that in the two weeks post-release from jail, people are eight times more likely to die, and 129 times more likely to die from drug overdose, than the general population," said Rousseau. "It is critically important that our county jails change their approach to dealing with opioid-addicted inmates, as the current approach of a majority of Michigan jails is unnecessarily increasing the death toll of this epidemic."

Jail administrators at the conference said a third or more of their inmate population is addicted to opioids.

Rousseau said that conventional wisdom suggests a cold-turkey withdrawal from opioids, while miserable, is not fatal. However, there have been occasions when an opioid-addicted inmate died as a result of drug withdrawal with no medical treatment. Macomb County jail is currently defending against a lawsuit brought by the family of an inmate who died in the jail as a result of drug withdrawal in 2014.

Oakland, Eaton, and Kent counties are working to implement programs that will provide opioid-addicted inmates with medication-assisted treatment, in the form of methadone, buprenorphine (Suboxone), or naltrexone (Vivitrol). And an increasing number of county jails, including in Lapeer and Macomb counties, are offering opioid-addicted inmates Vivitrol shots upon release from jail. Vivitrol is an opioid-blocker that prevents a person from getting high from opioids for close to month. Providing Vivitrol to an opioid-addicted inmate upon release will give that person a few weeks respite from opioid use to allow the person to pursue addiction treatment.

During her presentation, Rousseau argued that all county jails should work to implement programs that would use medications to ease withdrawal symptoms of opioid-addicted inmates and reduce the likelihood of drug overdose upon release. Developing and implementing such programs would require collaboration with community partners, including county leadership, community mental health agencies, drug courts and nonprofit organizations such as Families Against Narcotics.

"This is not something that jail administrators can develop and implement by themselves," said Rousseau. "Addiction treatment programs that include medications require additional administrative staff, funding, and medical expertise. Changing the way our county jails treat opioid-addicted inmates demands a collaborative effort on the part of multiple community stakeholders."

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