Editor’s Note: This op-ed/editorial was written by Peter J. Koutoujian, Sheriff of Middlesex County, Massachusetts. This piece is part of our Special Series on Addiction Treatment within Correctional Facilities. We’re grateful to Sheriff Koutoujian for sharing his perspectives.

For those suffering from addiction sentenced to a period of incarceration in the Middlesex House of Correction we work every day to answer that question in the affirmative.

Right now we are witnessing a frightening number of deaths due to opioid overdoses across the Commonwealth of Massachusetts. Heroin and other opioids are mercilessly taking the lives of users while leaving loved ones left to grieve and ask why.

Policy makers and those in government – myself included – are searching for answers As the former chair of the Commonwealth’s first OxyContin Commission in 2005, I heard the stories of how an increasing prescription drug abuse problem was feeding an equally expanding heroin problem. Almost a decade later as Sheriff, nearly 50 percent of inmates participating in our most intensive drug treatment program in 2014 reported heroin/opioid dependency as their most pressing drug problem. This is a significant percentage of our population that quite honestly represents the more fortunate – those who are getting the help they so desperately need – even if comes at the cost of incarceration.

Every day at the Middlesex Sheriff’s Office we use the unique window of opportunity we have with those struggling with addiction by utilizing a host of programs and tools to assist in their recovery. We’ve invested more to expand our drug treatment programs to offer inmates services, including our Accountability Recovery Community (A.R.C.).

An intensive 90-day program, A.R.C. participants reside in our 126-bed Residential Substance Abuse Treatment (RSAT) housing unit where they can dedicate each minute to their recovery. In 2014, we were designated as a National Mentor Site by the U.S. Department of Justice’s Bureau of Justice Assistance for this program and hosted 30 professionals from across the country for training this past May.

Those inmates who participate in the A.R.C. program are encouraged to tackle their addiction head on through an evidence-based curriculum. They focus first on their own recovery and second on supporting the recovery of those in the program with them. Additionally a priority is placed on getting participants to think about the impact their addiction has had on those around them including spouses, children and friends. And finally, participants are challenged to reimage themselves and stop thinking of themselves in negative terms. We don’t want them to think of themselves as addicts, but rather as fathers, sons and friends and set long-term goals for success.

At the Middlesex Sheriff’s Office we take a holistic approach by addressing drug addiction from every angle. But what is going to make an individual successful when they leave our custody depends on their will and the resources available to treat their addiction. That is why continuity of health care is critical.

We can be as aggressive as we want when it comes to treating addiction on the inside, but there must be an infrastructure available once these individuals return home. Provisions included in the Affordable Care Act allow for expanded treatment for drug addiction as well as medications, such as Vivitrol, to treat this disease. Vivitrol, a long lasting form of Naltrexone, is a non-opiate based medication that differs from Suboxone in that it carries no street value and is administered by a physician. The effects of one injection can reduce cravings for 30 days and many health insurance plans now cover the cost. That is why ensuring individuals have medical coverage is key to recovery.

Drug addiction devastates the lives of those who suffer from it, as well as their families and loved ones. By working smartly and creatively, our goal is to use incarceration as a way to help save lives.

My ultimate goal, however – and one shared by my fellow founding members of Law Enforcement Leaders to Reduce Crime and Incarceration – is to divert as many of those facing low-level drug offenses away from jail and towards treatment and support services in the community.

Peter J Koutoujian

Sheriff of Middlesex County, Mass.

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