OSSIPEE — Federal courts recently ruled that drug addicts are entitled to medication-assisted treatment (MAT) while incarcerated.
Now, Carroll County officials are trying to figure out what to do about it.
In a letter dated June 27, the American Civil Liberties Union of New Hampshire told Carroll County that a federal court in Maine and the U.S. 1st Circuit Court of Appeals agreed that a woman being held in Aroostook County, Maine, was entitled to a medication called buprenorphine while incarcerated.
The drug is a powerful painkiller and is used to help people reduce or quit their use of heroin or other opiates.
The 1st Circuit Court, based in Boston, has jurisdiction over New Hampshire.
Carroll County Corrections Superintendent Jason Henry spoke to county commissioners about the issue June 27. He also shared a letter he had drafted for the delegation, the 15 local state representatives who pass county budgets.
"We are in the process of updating policies and procedures around this issue, but my concerned is the price tag," said Henry. "We are the second-smallest jail in the state, and we are looking for an increase to our budget, somewhere around $100,000. We have no choice but to implement MAT as the courts have made their rulings."
The jail has a budget of just under $4 million.
Henry’s letter encouraged the delegation to look at a bill that U.S. Rep. Annie Kuster (D-N.H.) filed to authorize the U.S. Attorney General to make grants to local governments for the purpose of facilitating MAT.
"I'm hoping we can find a way to fund this without raising local taxpayers' dollars," Henry's draft letter said.
The letter also invited delegation members to a July 24 meeting at the county nursing home to discuss the jail's Transition Re-Entry Under Supportive Treatment Program, which began in 2016 and helps offenders reorganize their lives. Funding came from a $200,000 grant secured by U.S. Sen. Jeanne Shaheen (D-N.H,) and Gov. Chris Sununu.
Henry now is seeking a grant of $600,000-$800,000.
Carroll County Commissioner David Babson wanted to know how the jail programs are doing, saying, "I want to find out if the money we invested is proving worthwhile."
At the commissioners' July 3 meeting, Henry went over the ACLU’s letter with them and stressed that the county has "no choice" but to offer MAT. He said the county will incur costs when it starts offering Suboxone and other drugs used to wean addicts off heroin.
"Personally, I'm against it," said Chairwoman Amanda Bevard, who was under the impression that the addiction medications and the opioid manufacturers are "the same ones."
When Bevard asked whether the jail is seeing "more drug-related people coming to visit," Henry replied that at least 90 percent of inmates have substance abuse issues. Some commit crimes to fuel their addiction.
"Three weeks ago, we had two overdoses in one cell," said Henry, adding those people were given Narcan and sent to the hospital. "We are seeing more drugs packed inside people (who are) then taking them."
Henry said Narcan (naloxone) use, an overdose antidote, is way up statewide and at the jail. Naloxone is preventing the death toll from being much higher.
Jail staff also are seeing people mixing fentanyl and methamphetamines, Henry said.
In response to a question from County Administraor Ken Robichaud, Henry said it would be "helpful" if the county had a body scanner X-ray machine so they could search body cavities.
"If we believe somebody is on a substance or anything along those lines, we will dry tank them, turn off all the water and we have to go through all their stool and urine to make sure they have nothing in them," said Henry. If days go by and there's still a concern, the inmate is taken to Rockingham or Strafford counties, which have body scanners.
The jail's dog can't sniff drugs that are inside someone's body and wrapped, he said.
Henry said a year and a half ago, an incarcerated woman who was packing drugs inside herself died of an overdose.
"Apparently, the approach we as a society are using isn't working," commented Bevard.
At the Sun’s request, James Stoddard, the jail’s program director, provided statistics about drug use In Carroll County and the state of New Hampshire. over the past few years.
Sixteen opioid deaths were recorded in 2016; 12 in 2017; nine in 2018; and six deaths this year through May. In 2016, there were 175 opioid-related emergency room visits in 2016; 107 in 2017; 110 in 2018; and 43 from January-May of 2019.
As for Narcan, it was administered 91 times in 2016, 68 times in 2017, 62 times in 2018 and 30 times from January through May.
Statistics shared by Stoddard showed meth deaths are up in New Hampshire. In 2015, there were two meth-related deaths, rising to 13 in 2016, 15 in 2017 and 22 in 2018.
“I do think that the data suggests that we are in a changing drug environment where meth is on the rise and opioids are still a significant issue,” said Stoddard. “There seems to be a trend where people are using meth and opioids in various combinations.
”I think it’s reasonable to conclude that the problem is getting worse in many ways,” he said.