From path to prison to the road to wellness
The noted American psychologist Abraham Maslow once said that when the only tool in your tool chest is a hammer, you view each problem as a nail.
I can’t think of a better analogy to represent Pennsylvania’s historic approach to addressing the drug epidemic that is upon us.
Because most drugs are illegal, our primary approach has been a law enforcement one. In other words, we hammered drug addicts.
Perhaps a better analogy today is an “inner tube” approach to solving this complex problem, wrapping someone who is suffering with the right services to keep them from being yet another inmate number.
While fully acknowledging drug kingpins need to be identified, arrested and incarcerated for long periods of time, merely responding to the “supply” side of the drug equation has proved inadequate. Instead, we are working toward attacking the “demand” side in a more holistic way with effective, research-based, and properly-dosed treatment plans. This is an essential component of a modern approach to addressing the current opioid drug epidemic, and that’s what Gov. Tom Wolf and those of us on the frontlines of confronting substance-abuse disorders are moving quickly to put in place.
According to a recent analysis by the Drug Enforcement Agency Philadelphia Field Division, 3,383 Pennsylvanians – approximately nine people per day – died from drug-related overdoses in 2015. More distressing is this is a 23.4 percent increase from the number of drug-related overdose deaths (2,742) in 2014.
Clearly, business as usual is not working.
Our conceptual framework is predicated on the assumption we need to “divert” drug users out of the criminal justice system. Now, while we certainly need to get folks who are addicts out of the criminal justice system, why put them there in the first place? Absent our current point of reference, if we were designing a system to effectively respond to the scourge of addiction, our first step would be to move the individual into a system that had the greatest likelihood of actually addressing the addiction.
Note this doesn’t put them in a system that we know isn’t designed to achieve the goal. Rather, it is to put them directly in the proper system. So now, the question becomes, how to perpetuate this approach given the current legal and historical restraints?
The approval of the 2016-2017 budget means Wolf can dedicate $20.4 million to fund 20 Centers of Excellence across the commonwealth to treat 4,500 Pennsylvanians with opioid use disorder in the first phase of the program. Rather than solely treat the addiction, this program will treat the whole person, providing a network of support and coordination to ensure those who need help do not fall through the cracks. The use of medication coupled with wrap-around supportive services, can prevent people from relapsing and improve their chances for recovery.
Last month, I joined national leaders at the White House for a conference hosted by the Office of National Drug Control Policy, designed to raise awareness about the importance of including medication assisted treatment as part of a comprehensive treatment regimen in prisons.
As part of our “behind-the-walls treatment,” the department is working to reduce criminal behaviors through individualized Substance Abuse Disorder treatment and education to ensure successful community reintegration.
The number of individuals entering state prisons with opioid-addiction has doubled over the past 10 years, from 6 percent to 12 percent. Roughly 68 percent of inmates have substance abuse problems.
The DOC is tailoring comprehensive drug and alcohol treatment to inmates through a variety of services, including assessment, outpatient care, inpatient care or aftercare. We launched a pilot program using Vivitrol, a long-acting injectable form of naltrexone that blocks certain receptors to prevent a high and removes the craving for drugs or alcohol. Under that program, female inmates at SCI Muncy received an injection prior to leaving and then five subsequent injections after release.
As a result of the program’s success, it was expanded to include male inmates at four additional prisons, and we directed $1.5 million in grant funding to county prisons for Vivitrol use.
The Department of Corrections is not seeking to be the model for addiction treatment in the commonwealth, but we want to be part of the solution to the opioid epidemic. The goal for all of us should be addressing the root cause of crime and, in the case of drug addiction, diverting those individuals from the path to prison to the road to wellness.
Wetzel is the secretary of corrections for Pennsylvania.