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Linda Drummond remembers the pain she felt withdrawing from heroin addiction while in jail more than 10 years ago.

The symptomsbloody nose, diarrhea, vomiting, dizziness, sleeplessnesswere often so severe she couldn't get out of bed and sometimes had difficulty physically functioning when called to court.

"They do nothing for you in the jail right now when you go through withdrawal," said Drummond, 56.

Once out of jail,  - - -  -Drummond was eventually able to kick her habit using methadone, a medicine that stabilizes an addict by acting like heroin without damaging the person's body or providing the euphoric highs often associated with the drug.

Methadone treatment may be available to King County Jail inmates under a pilot project being offered through Public Health — Seattle & King County. If approved,  --  the Jail-based Opioid-Dependency Engagement and Treatment Program (JODET) would start in 2006 and would be only the second such program in the nation.

Mark Alstead, JODET's Director, said there are normally,  between 300 and 400 people in the county's jails who are dependent on opioid substances like heroin. If their addictions are not treated, he said, they are likely to continue using and committing crimes once released.

Many of those people return to jail, over and over again, and that's expensive," Alstead said. "In addition to the monetary savings there, the idea is to interrupt that cycle of people who are in and out of jail ... over and over again."Alstead said the $350,000 pilot program, to be funded by local tax dollars  .... as part of the county's criminal-justice initiatives, grew out of recommendations from former Seattle Mayor Paul Schell's Heroin Task Force. The program is subject to approval by two state and two federal drug-treatment agencies.

The heroin task force was created in 1999, a year after deaths in King County from opioid addiction,  including heroin and other drugs  such  as codeine or OxyContin, hit a high of 144. 

Alstead said if the county can get those who are addicted to heroin hooked on methadone while in prison, they will continue to use methadone once released and will not commit as many crimes in the community to sustain their former habit.

The only other methadone-treatment program for addicts entering correctional facilities started almost 20 years ago at the Rikers Island jail in New York.

Alstead, who visited Rikers last year, said JODET is modeled after that program.

A 2001 report published in the Mount Sinai Journal of Medicine by researchers studying the Rikers Island program  noted  that  "Patients are demonstrating a remarkably low rate of recidivism, given their long history of drug involvement."

Ron Jackson, who has been the Executive Director of the Evergreen Treatment Center, a King County methadone clinic, for 26 years, said the number of patients served at Evergreen in the past 10 years has skyrocketed from 200 to about 1,200.

Punishment doesn't work," Jackson said. "One way to both save  [inmates]  as well as save the community a lot of burned-up resources is  helping  them  get into treatment."Once the program went into effect, addicts entering jail would be eligible for a 12-day methadone treatment to help them through withdrawal symptoms.  After the 12 days, only those offenders convicted of a misdemeanor or low-level federal offense would be eligible for methadone treatment through-out their stay in jail.

Alstead said the pilot program hopes to accept between 50 and 100 inmates. After being released from jail, those in the program would receive vouchers for methadone at local clinics like Evergreen.

A social worker inside the jail would also help inmates in the program plan for life after incarceration, including assistance with housing and medical care.

Methadone treatment in Washington has been controversial particularly due to community concerns about locations of methadone clinics that critics say would attract crime and loitering. But Alstead said he has encountered little resistance to the jail program because it is not being placed in a community.

While forming JODET, Alstead and others consulted people like Drummond who have first-hand experience with the effects of heroin and the benefits of metha-done.

"I think when you go into jail and get on the methadone when you're in jail, I think you have a lot better chance of making it and staying on methadone," Drummond said.

Nadelman said, "...forcing people to go through withdrawal
without continued methadone treatment causes an 80 to 90
percent relapse rate."

Ethan Nadelman, Director of the Drug Policy Alliance based in New York, said that  forcing people to go  through  withdrawal  without  continued  methadone treatment causes an 80 to 90 percent relapse rate. "When people leave a jail or prison, it is among the most common times of people to overdose on heroin or opiates and die. [Or] they go back on the streets and [keep] using, " Nadelman said.  Drug-treatment programs like JODET are slowly developing around the country,and some experts say they reflect a shift from punishment to rehabilita-tion in the nation's correctional facilities.

David Olson, a professor at Loyola University in Chicago, is closely monitoring   a prison that opened in Illinois less than two years ago devoted solely to drug treatment, although it does not use methadone.

"There seems to be a pendulum swing back to rehabilitation and to provide services," Olson said. "[If offenders are] not receiving any type of treatment, they're getting released and rearrested. The program here was designed to break that cycle ....... Seems to be if we don't do anything with them while they're incarcerated, they're going to come out just as bad if not worse."

Reena Szczepanski, Director of the New Mexico Drug Policy Alliance, said she was able to use similar logic to help establish a program similar to JODET in Bernalillo County. The new policy provides methadone to those already on the medicine if they re-enter the county's jails.   Unlike JODET, it does not provide treatment for addicts not on methadone.

It is illogical not to continue treatment for offenders, - - - if they are rearrested, Szczepanski said, because they will turn to illegal and contraband heroin while incarcerated and get hooked on the drug again. "Within the next five years it is going to be the standard of care if cities like Albuquerque and Seattle continue to take the lead and show that this is effective," she said.

Methadone treatment for those behind bars has become the standard of care in many other countries.

The medicine was introduced into the New South Wales Corrections System in Australia in 1987 as a way to combat high rates of Human Immune Virus in the Correctional Facilities because of needle sharing, - - said Kate Dolan, a Senior Lecturer with the National Drug and Alcohol Research Center at the University  of New South Wales.  - Dolan said it has been so effective that the number of inmates with Human Immune Virus is down to 20 out of about 8,000.

Drug-related treatments are greatly reducing the levels of Human Immune Virus, Hepatitis B and C, and Tuberculosis in many prisons across Europe, according to a report on Substance Abuse in Prison published by the World Health Organiza-tion in May.

Inmates on methadone were also 70 percent less likely to return to prison eight months after their release, - - - wrote Alex Wodak, Director of Alcohol and Drug services at St. Vincent's Hospital in Australia.

Correctional facilities in the U.S. have a History of Abstinence-Only approaches to Drug Treatment, something Jim Thorsteinson of Vancouver Coastal Health, one of Canada's largest Public Health-Care Providers, said doesn't work.

Thorsteinson said Methadone-Treatment programs in Canadian Correctional facilities have been beneficial in stabilizing addicts' lives and saving money for the community.

"It's a compassionate and pragmatic approach, rather than 'sink or swim,' " he said.

Ari Bloomekatz: 206-464-2540 or abloomekatz@seattletimes.com

Copyright © 2006 The Seattle Times Company

         Methadone Maintenance
  For King County (Seattle)
  ' Imprisoned Addicts'

King County, Washington, jail and public health officials are seeking approval to start providing methadone to prisoners addicted to heroin and other opiates, The Seattle Post-Intelligencer reported Tuesday.

Only one other jail in the country, New York City's Rikers Island, now currently is offering Methadone Maintenance for prisoners.

A synthetic opiate,methadone is used as an oral opiate substitute for people strung out on other opiates,such as heroin, morphine, or oxycodone, the main ingredient in Oxycontin. 

Methadone  Maintenance Therapy has  been found to help addicts stabilize their lives, thus reducing public costs of addiction by reducing drug-related offenses and emergency room expenditures.

"It's going to save taxpayer money in the long haul and plus give people a chance  for a better life," Deb Cummins, a Drug Treatment Manager with the State, told the newspaper.

King County has already budgeted $200,000 for staffing and medications for 2006, as well as an additional $150,000 for community treatment vouchers for inmates on their way out jail.

But Methadone Maintenance Therapy is governed by a Thicket of Bureaucracies, ranging from Federal Drug Enforcement Administration and Center for Substance Abuse Treatment to the Washington State Board of Pharmacy and Department of Social and Health Services (DSHS), making approval an arduous process.  DSHS is  now currently considering the King County Health Department's application for certification, the first step in the process.

On any given day, the King County Jail holds between 300 and 400 opiate-addicted inmates, said Mike Alstead, head of the Jail Opiate Dependency Engagement and Treatment program (JODET).  According to the county's application, the program would start next Spring and eventually provide methadone for between 50 and 100 patients per day.

The target population will be long-term addicts arrested for misdemeanors or not-so-serious felonies, Alstead told the Post-Intelligencer.

The program also envisions a separate, short-term program for incoming inmates who are addicted,but don't enroll or qualify for the program. Those inmates would be given a twelve-day,low-dose Methadone Program, to get them through physical withdrawal.

"What we're trying to do is focus on the people who have The Opioid Dependency but are also the ones who return to jail again and  again so we can interrupt that cycle," said Alstead."


--- 4-Star General Barry McCaffrey, Top U.S. Drug Treatment CEO Barry Karlin To
Join N.M. Secretary of Health Grisham Announcing National Model Methadone Treatment For Opiate-Addicted Prison Inmates

---Program First In Southwest United States 

---1 p.m. Monday, March 6, Metropolitan Detention Center, 100 John Dantis Drive, SW, Albuquerque, New Mexico

---Media Also Welcome On Tour To Follow

Four-Star General Barry McCaffrey, who was the country's longest serving Drug Czar from 1995-2001, now National Security Professor at West Point together with Dr. Barry Karlin, CEO of CRC Health Group, The Nation's Largest Drug Treatment Provider, join New Mexico Secretary of Health, Michelle Lujan Grisham Monday  at a news conference announcing a model Methadone Drug Treatment Program for Opiate-Addicted Prison Inmates

The unique program is the first in the Southwestern United States (only five other programs are underway in the  United States - New York, Baltimore, Providence, Orlando, and Seattle).

The announcement will be at 1:00 p.m., Monday, March 6,2006 at the Metropolitan Detention Center, 100 John Dantis Drive,South West, Albuquerque, New Mexico, in the Conference Room of the Jail, near the entrance.  Following the announce-ment, media will be welcome on the tour to follow, to see the Medical Clinic and talk to inmates prescribed Methadone.

The Methadone Maintenance Treatment Program at MDC is a joint collaboration between the Metropolitan Detention Center, the State of New Mexico Department of Health, CRC Health Group, Correction Medical Services, and the State of New Mexico Methadone Authority. The new treatment program allows for methadone treatment for prisoners actively enrolled in a methadone program at the time of their incarceration if they meet specific criteria including a sentence of less than   a year, last methadone dose within the last two weeks, and wishing to participate. The program also provides regular counseling at the client's request.

General McCaffrey as Drug Czar and since has strongly advocated drug treatment for the prison population because of the link between drugs and crime-60 percent of arrestees have tested positive for illegal drugs in 30 cities in DOJ surveys, and some experts place the numbers even higher.

"Drug treatment for the prison population provides an opportunity to reduce crime and recidivism in a prime target group and it can make a big difference in crime," General McCaffrey stated. "The New Mexico Methadone Program will help addicts who otherwise would return to heroin, OxyContin, and other opiates, as well as a life of crime. This is a national model program with huge potential. I congratulate Secretary Grisham and Governor Richardson."

CRC Health Group provides the methadone and supervision for the program. CRC CEO Dr. Karlin commented: "CRC Health Group is proud to participate in the joint collaboration treating a population with a great need.  Secretary Grisham's vision will be a model for Drug Treatment across the nation.This kind of Drug Treatment may be the most effective anti-crime action we can provide, and yes it can restore productive lives."


2006 U.S. Newswire 202-347-2770/   1 March 2006

 - - - Methadone was introduced  in New South Wales Correctional  System in Australia  in 1987  to combat
Human Immunodeficiency Virus from sharing needles
said Kate Nolan. It has been so effective the number of inmates is down to about 20 out of 8,000 inmates!!! 
 Kate Nolan, Senior Lecturer with National Drug and Research Center       Can you believe it?
   We need it in all of them?                  

Created and Compiled by:  Deborah Shrira, RPH,CMA             11 March 2006