After 18 Months, CODAC Partnership with Mass. Sheriff’s Department Getting Results

A collaboration between the Hampden County (Massachusetts) Sheriff’s Department and CODAC Behavioral Healthcare to provide medication-assisted treatment to incarcerated individuals with substance use disorders is making headway 18 months after its inception.

To date, 1,586 patients (1,187 male, 399 female) have been treated in the program since it launched on Sept. 1, 2019. As of Feb. 28, 2021, 178 patients are receiving MAT. Patients have been prescribed one or a combination of the following medications:

• Subutex – 912 patients
• Methadone – 499 patients
• Vivitrol – 230 patients

The majority of patients (887) have been white, followed by those who are Hispanic (407). Patients mostly are young to middle-aged adults, falling within the ages of 25-34 (764 patients) and 35-44 (584 patients).

In an interview with Addiction Professional in 2019, CODAC president and CEO Linda Hurley credited Hampden Sheriff Nicholas Cocchi for “jumping in head first” when the opportunity to develop a MAT program arose. Whereas some within the advocacy community considered the facility an inappropriate venue for treatment, Cocchi saw the program as a way to potentially reduce recidivism.

Individuals with an active MAT prescription entering HCSD custody are allowed to continue their treatment regimen after receiving approval, which usually comes within the same day as intake. Those in custody who report a form of SUD for which the aforementioned medications are deemed helpful are assessed by staff and started on MAT as appropriate. In addition to providing medications as part of treatment, CODAC and HCSD staff facilitate individual and group therapy sessions. Upon their release, HCSD connects individuals with providers within their community to continue treatment. Patients actively being treated with medications are connected with a licensed MAT clinic where they live.

COVID complications

The onset of the COVID-19 pandemic proved challenging for program leaders. On April 3, 2020, the Massachusetts Supreme Judicial Court ordered lower courts to review certain individuals for an early release from custody. Robert Rizzuto, a communications specialist with the sheriff’s office, told AP in an email that the unpredictable nature of inmates being released due to COVID concerns was among the department’s biggest complications.

“Our MAT staff reports that they began treating any court appearance as a potential release date, and planned accordingly to ensure continuity of treatment in an ever-changing timeline,” Rizzuto said.

For CODAC, the pandemic posed serious staffing challenges, as individual employees became exposed to the virus or tested COVID positive, Hurley told Addiction Professional in an email.

“The way we overcame this was by working collaboratively with the sheriff’s department so that we shared staff – counseling, assessment, administration, etc. (and all within federal and state regulations) – so that the full array of our treatment services continued to be provided and we did not lose any ground in delivering addiction treatment to the individuals within the sheriff’s custody,” Hurley said.

“Also, there were times when the jail needed to ‘shut down’ and no one from the outside could enter until the virus was under control again within the jail.  And again, we dealt with that by collaborating with staff who were already inside and could continue essential aspects of the treatment until our CODAC providers were allowed back in.” 

Changing attitudes

In the year and a half since its launch, the tenor of some conversations about the use of MAT have changed. Hurley said CODAC has received more requests from neighboring communities in western Massachusetts, which she attributes to the success in Hampden County.

Added Rizzuto: “As more departments jump on board and show positive results, the public education evolves to acceptance and embracing the science. We believe MAT when done in conjunction with individual and group therapy shows promising results, helping people return to their families and communities healthier and on a much more positive trajectory than when they first came to us. And that result, a positive transformation, is the drive behind all we do.”

Photo provided by CODAC Behavioral Healthcare and the Hampden County Sheriff’s Department.