Some pris­on­ers leav­ing jail armed with over­dose kits

Northwest Arkansas Democrat-Gazette - - NATIONAL - DON BABWIN

CHICAGO — Chicago now gives at-risk in­mates the over­dose-re­vers­ing drug nalox­one upon their re­lease from jail and Los An­ge­les is poised to fol­low suit, putting the an­ti­dote in as many hands as pos­si­ble as part of a mul­ti­fac­eted ap­proach to fight­ing the na­tion’s opi­oid epi­demic.

The Cook County jail in Chicago, the largest sin­gle-site jail in the coun­try, has trained about 900 in­mates to use nalox­one nasal spray de­vices since last sum­mer and has dis­trib­uted 400 of them to at-risk men and women as they got out. The de­vices can undo the ef­fects of an opi­ate over­dose al­most im­me­di­ately and are iden­ti­cal to those used by of­fi­cers in many of the coun­try’s law en­force­ment agen­cies.

Sher­iff Tom Dart, whose of­fice runs the jail, said ad­dicts are most at-risk of fa­tally over­dos­ing in the two weeks af­ter get­ting out be­cause of their time away from drugs while locked up.

“We’ve got to keep them alive [and] if we can get them through that two-week win­dow, they might get treat­ment, get off drugs,” he said.

Dr. Con­nie Men­nella, the chair­man of Cor­rec­tional Health for the county’s health and hos­pi­tals sys­tem, which ad­min­is­ters the pro­gram, said only in­mates are be­ing trained to use nalox­one, but that she even­tu­ally hopes their rel­a­tives and friends also can be trained.

“We are try­ing to sat­u­rate this com­mu­nity with this drug and we are ed­u­cat­ing them to tell their buddy, mother, fa­ther how to use it, where they keep it and, ‘If you come home and see me not re­spond­ing, to go get it and use it,’” she said.

Pro­po­nents say such jail pro­grams can be the dif­fer­ence be­tween a for­mer in­mate liv­ing and dy­ing, as the nalox­one of­ten can be ad­min­is­tered by an over­dos­ing ad­dict, a friend or fam­ily mem­ber be­fore emer­gency re­spon­ders can reach them.

Dr. Aras­tou Amin­zadeh, the cor­rec­tional health-med­i­cal di­rec­tor for the Los An­ge­les County Depart­ment of Health Ser­vices, said the kits are par­tic­u­larly im­por­tant for just-re­leased in­mates be­cause the same amount of drugs they once used to get high be­fore they were locked up could now kill them.

“Their thresh­old has dropped but they may use the amount of drugs they used to use,” said Amin­zadeh, who is help­ing Los An­ge­les jails pre­pare to be­gin its nalox­one pro­gram early next year.

It is too soon to gauge the ef­fec­tive­ness of Cook County’s pro­gram, but Dart said anec­do­tal ev­i­dence sug­gests that the kits have saved lives, in­clud­ing a man who was ar­rested again, re­turned to jail, and told of how a friend he had trained to use the kit had done so when he over­dosed.

In New York City, more than 4,000 kits have been dis­trib­uted to friends and rel­a­tives of in­mates at the city’s jail at Rik­ers Is­land since the pro­gram there was started in 2014.

“We did a sur­vey of their use of the kits af­ter six months and 226 peo­ple re­sponded to the sur­vey and found 50 us­ages [of the nalox­one], and found that 87 per­cent of the over­doses where the nalox­one was used, [the vic­tim] sur­vived,” said Dr. Ross MacDonald, di­rec­tor of health ser­vices for the city’s cor­rec­tional di­vi­sion.

Oth­ers have also seen en­cour­ag­ing re­sults. In Rhode Is­land, a study of 100 in­mates found they were able to suc­cess­fully ad­min­is­ter the drug af­ter be­ing re­leased, with a few us­ing it to re­v­erse their own over­doses. A study in Scot­land, mean­while, found that the num­ber of opi­oid-re­lated in­mate deaths dropped within the first four weeks of re­lease af­ter nalox­one kits were dis­trib­uted.

The grow­ing con­sen­sus is that nalox­one works. Three years ago, the World Health Or­ga­ni­za­tion re­leased guide­lines rec­om­mend­ing ex­panded nalox­one ac­cess to peo­ple likely to wit­ness an over­dose, in­clud­ing drug users. And the North Carolina Harm Re­duc­tion Coali­tion, which tracked the use of nalox­one kits by law en­force­ment agen­cies, re­ported that the num­ber of agen­cies that equip of­fi­cers with kits climbed from 971 to 1,217 in about eight months last year.

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