“You only have two options in this,” said former BrightView Health patient Carl. “You’re either going to end up in jail, or you’re going to end up dead.”
Carl, who we will be referring to by first name only because he is in active recovery, spoke with BrightView Health for their “Faces of Recovery” series about his recovery journey. Carl told BrightView he was literally headed to end his life and walked into one of their centers instead. The recovery center is working to reduce the stigma around medication-assisted treatment, known as MAT, for those with substance use disorders.
Reentry is the process in which a person who was formerly incarcerated re-enters society. BrightView’s Outreach Manager for Southern Ohio, Emily Harsh, said that for somebody with an opioid use disorder, it can be a very dangerous time.
“There’s been a lot of studies that show that within two weeks of post reentry, somebody is more likely to experience a fatal overdose than any part in their life,” she said.
BrightView has two Northern Kentucky locations: one in Covington and one in Erlanger. They offer same-day entry. Harsh said it’s essential for them to have an easy starting process. BrightView was founded on non-punitive, evidence-based approaches to substance use disorder treatment.
“Meaning that we don’t kick out individuals for experiencing the disease they’re seeking treatment for,” Harsh said.
BrightView offers individual counseling, group counseling, and medication-assisted treatment. However, BrightView said far too often that MAT, as part of a comprehensive treatment program, is not considered a viable option.
“We do have studies that show that for most folks, MAT is very, very beneficial in reducing fatal overdoses,” Harsh said. “We do discuss that upon intake, but at the end of the day, we put our patients in the driver’s seat of their care.”
According to BrightView, 65% of the nation’s prison population has a substance use disorder. Harsh said there are many barriers to accessing treatment for those in the justice system.
MAT helps to prevent fatal overdoses, Harsh said. If an individual is incarcerated and they’re not utilizing substances, specifically opiates, their tolerance has significantly dropped. Harsh said what happens is if that withdrawal isn’t managed through MAT medications when that person reenters society, there’s a good chance that they could go back to using.
“Typically, what we see is they go back to using the same amounts that they were previous to incarceration, now that their tolerance is dropped, we’re in a really scary situation with facing fatal overdoses,” she said.
While Harsh said the topic of insurance is boring, it is one of the biggest barriers to seeking treatment. She said BrightView works with as many insurance providers as it can, including Medicaid in all the states it serves.
“When somebody is incarcerated in most states, they do suspend the medical benefits of Medicaid, and the jail takes on the responsibility for their medical care,” Harsh said. “So, a lot of times in reentry, there can be some bumps in the road.”
Still, Harsh said they try to be as barrier-free as possible. For example, if someone was just incarcerated and does not have a state-issued ID, BrightView will accept their prison, jail or hospital discharge paperwork. They also set individuals up with case management services to help them get Medicaid if they qualify and walk them through the process to get their state ID.
BrightView Director, Content Marketing Kevin Dugan said in Northern Kentucky in the past, the approach for an inmate with a substance use disorder was punitive. They would go to court and get jail or prison time without treatment.
“More and more prison systems, jails, are providing that support,” Dugan said. “Kenton County is one of them, which is great. There’s a drug court now that’s happening, so that you can get treatment in lieu of going to prison.”
In 2015, the Kenton County Detention Center hired Jason Merrick, a certified drug and alcohol addiction counselor with degrees in social work, as the addiction services director.
Most recently, in February, Kenton County announced that mental health and addiction service treatment services at the Kenton County Detention Center are moving in-house.
The Kenton County Detention Center will implement the Persistence, Accountability, Transformation and Hope program, also known as PATH. The program would function as an in-house outpatient program, enabling treatment access for everyone in the jail.
Kenton County Jailer Marc Fields and Merrick presented the new program to the Kenton County Fiscal Court during a meeting on Feb. 11.
Merrick told the fiscal court that the program was unique to Kenton County.
“Anybody in any dorm in the jail will be able to get referred into the program,” Merrick said at the meeting. “They’ll be able to get individual counseling, case management, re-entry services and group counseling, all within the detention center.”
Harsh said that punitive consequences don’t equal progress or abstinence.
“The most important thing is that therapeutic alliance,” she said. “There’s been a lot of studies that show one of the most important indicators of a positive outcome is how strong of a therapeutic alliance the individual feels about the people that are treating them.”
Harsh said they lean on their justice system partners to help ensure treatment is successful.
“I think it’s a really beautiful relationship because they can support individuals in a much different way than we can support them and vice versa,” Harsh said. “We really value that collaborative approach through just making sure that everybody’s on the same page with where we are in treatment and shared goals.”
Harsh said another program at Kenton County that BrightView works with them on is the HEART program.
HEART’s goal is to get people who face low-level, non-violent offenses out of jail and into meaningful, intensive treatment as soon as possible. Counselors conduct in-jail evaluations that examine history, background, resources, family, insurance, and housing status to determine the best fit for treatment.
Harsh said there are still misconceptions that surround MAT.
There is a lot of stigma about the medications, which Harsh said she thinks comes from a place of miseducation.
“It’s really important to understand that we have three medications approved by the Federal Drug Administration to treat opioid use disorder,” she said. “We have three, and any other disease you would find, say you have a heart condition, you would have just a host of medications and interventions to choose from.”
Dugan said people will say MAT is just substituting one addiction for another, but that’s not even close to being true.
“One we’re talking about FDA approved,” he said. “Medicine that is being prescribed and provided to stop their cravings and their withdrawal issues, so that they can focus on changing their behavior.”
Dugan said it all goes back to realizing that addiction is a disease.
It’s the difference between an addiction and a chemical dependency, Harsh said. She said if someone were to stop taking their Lexapro and have withdrawal symptoms, that’s a chemical dependency. Addiction has negative behaviors tied to them.
BrightView Health is having a free, online webinar on March 19 to help educate more about MAT. More information and registration for the event can be found here.
Now three years into sobriety, Carl said he wanted to get help.
“Don’t be afraid to come in and get help,” he said. “Don’t let other people’s judgement deter you from getting the help.”
If you or someone you know is struggling with a substance use disorder, you can contact BrightView Health at 888-502-4571 or go to BrightViewhealth.com.
