OSSIPEE — Despite efforts to convince them otherwise, a majority of Carroll County commissioners on Wednesday morning voted against the jail superintendent’s proposed policy on Medication Assisted Treatment for inmates who aren’t already on such a program.
Since early summer, jail superintendent Jason Henry has been trying to implement medication-assisted treatment, known as MAT, to help drug-addicted jail inmates.
But at the Sept. 25 meeting, Commissioner Amanda Bevard (R-Wolfeboro) said she wondered whether the county jail should introduce inmates to medications like Suboxone if the drugs hadn't been prescribed by a doctor before the inmate entered the facility.
Henry had asked the commissioners last week to see if they would would sign off on the policy. Though Commissioner David Babson (R-Ossipee) said he would support the policy, Bevard was opposed and Commissioner Terry McCarthy (R-Conway) was absent.
Last week, Henry said he would come back when there was a third commissioner, meaning when McCarthy returned.
On Wednesday, the full board of commissioners was present. Henry again brought his policy forward as well as bringing along Carroll County Coalition for Public Health Facilitator Catalina Concha Kirsch and New Futures Community Engagement Coordinator Katie Foster to speak to the benefits of MAT.
Kirsch said the medication is given on a prescription basis and offers people a better chance of getting well. She said the treatments can be continued in the community and that the jail does pre-release planning to make sure inmates can get care post-incarceration. She compared addicts getting MAT to diabetics being given insulin.
Henry said Suboxone cut cravings for the drugs. Without it, addicts tend to focus on getting their next fix rather than on treatment programming. He said MAT would reduce overdose deaths.
But Bevard said: “I haven’t found facts to back that up. I keep asking for just some numbers, some data and some research.”
Kirsch and Foster pointed to information from the Substance Abuse and Mental Health Services Administration. They said numbers from 2018 show that when prison inmates go without MAT, the risk of overdose death within weeks of release is 10 to 40 times higher.
The study was from “Beyond the Walls: Risk Factors for Overdose Mortality Following Release from the Philadelphia Department of Prisons” in the Drug and Alcohol Dependence Journal.
Bevard asked the women to email her the information.
Kirsch said fewer people had been dying of overdoses in the community since treatment programs became available. Bevard thanked the Kirsch for the effort.
Kirsch said it was a result of a “big team” effort that included Henry. She said there’s more work to do. “I appeal to you as the commissioners to help and cooperate and support efforts that help people get healthy,” said Kirsch.
Earlier Bevard had said the “wonderful progress” occurred without introducing MAT to inmates.
After a 40-minute discussion on MAT, McCarthy sided with Bevard to vote 2-1 against Babson’s motion to support Henry’s policy.
“Doctors have heralded medicines as the most wonderful thing in the world and have everybody on it and then found out it was not really all that helpful to the community,” said Bevard. “I think some pharmaceutical companies and their owners are in the midst of big lawsuits on that.”
Last week, Henry said that as superintendent he would implement the policy no matter what the commissioners decided. He said the jail’s contracted doctors have an obligation to provide the level of care that’s available in the community.
He said the rub would come when inmates receive the treatments and the bill comes due.
“The lawsuit, when it comes down, has my name attached to it,” said Henry. “I will protect the jail one way or another and, no offense, myself personally.”
Henry said his policy was written by doctors and is used at four other New Hampshire jails and other states. He said there are stringent requirements that inmates have to meet to be placed on MAT.
“This has not been an overly cumbersome issue for most of the other counties; it’s seem to become a cumbersome issue here (at) week No. 4,” said Henry. “I’ll come back for week No. 5. If it doesn’t pass, I’ll be back for week No. 6, 7, 8. I will keep bringing it forward.”
Bevard quipped, “You’re a school board member, aren’t you?” She was joking about school boards’ propensity to bring proposals over and over.
Henry sits on the school board in Barnstead.
McCarthy, before the vote, said it was a “hard choice.” She asked Henry how much MAT would cost the county.
Henry said he had “no idea.” He said doctor visits would cost $150, and then there would be costs for medications and blood work.
Rockingham County’s jail is three times the size of Carroll County’s. Henry said they have eight inmates on MAT, while Merrimack County has 12.
“You are not talking large populations,” said Henry. “Could it expand? Sure. I don’t know.“
McCarthy suggested amending the policy. She said it looked like to her that the beginning of the policy was saying that such inmates would automatically go on MAT when further on, the policy explains otherwise.
Henry said he wouldn’t change the policy. He said inmates have to be found to be on opiates before MAT can start. He said doctors can’t push Suboxone on inmates who don’t need it.
After the vote, Bevard said that if Henry came to the commissioners with a new policy that would allow for inmates to continue their treatment at the jail, she believed all three would support it.
“Speak for yourself, Madam Chairman,” said Babson. “I’m in favor of the policy that Superintendent Henry put forth.”