Methadone programs offer prisoners way to manage, treat their opioid addiction
"It's like the flu times 10," Daniel said from his perch atop a plastic chair within Bridgeport Correctional Center, his temporary home.
On top of the nausea and vomiting, achy bones, chills and hot flashes is a hypersensitivity so intense, even brushing one's teeth is hard, the 28-year-old Stratford resident explained.
"Sitting in this chair would feel like you were sitting directly on your spine," he continued, trying to find words to describe what opioid withdrawal feels like.
"You get all your feeling back at once," he said. "Drugs numb you."
But this time around — his third stint in a correctional center — Daniel didn't have to go through that.
On methadone before he was sentenced in March, Daniel, who agreed to speak for this article on the condition that his last name wasn't used, is one of about 55 inmates who get a daily dose of methadone through a state Department of Correction program operating at the Bridgeport and New Haven correctional centers.
Methadone, which has been recognized as a form of addiction treatment for more than 50 years, is an opioid that tricks the brain into thinking it's getting heroin or another previously abused opioid while allowing a person to feel normal rather than high.
In Connecticut, early feedback — the program in New Haven has been operating since October 2013 and the one in Bridgeport since February 2015 — shows keeping offenders on methadone while they're jailed is making a difference.
The case for methadone maintenance
Since methadone maintenance programs were first introduced to U.S. prisons and jails in the 1960s, countless studies have found that inmates participating in them have reduced rates of mortality, drug use and re-incarceration after release, compared with those who only have counseling.
In 2009, for example, a study of just more than 200 Baltimore inmates found that those who received counseling and methadone — as opposed to counseling only — spent seven times as many days in drug abuse treatment during the year after their release.
They also were less than half as likely to test positive for opioids during the same period.
According to state Department of Correction Director of Health Services Kathleen Maurer, although it's too soon to say whether those results are reflected in the Bridgeport and New Haven programs, correction officials and officers say there's been a marked improvement in terms of the inmates' behavior — and, as a result, the overall environment in their jails.
According to the National Institute on Drug Abuse, only about 15 percent of state prisoners and 17 percent of federal prisoners take part in medication-assisted drug treatment programs.
"There is still a sense that people should be punished instead of treated for addiction," said John Hamilton, chief executive officer of the multifaceted nonprofit. "Some people want to be 'tough on crime,' but this is being smart on crime. People don't understand the impact this can make."
Of those who are incarcerated in Connecticut — 15,460 as of Friday — between 75 and 85 percent have substance use disorders, according Maurer.
About a quarter of them are addicted to opioids, she said.
"The number of people in our system who have a drug problem is huge," Maurer said, noting what she called a "striking" statistic: In Connecticut in 2015, about 42 percent of those who died of accidental overdose had been in corrections at one time or another.
"There are a lot of people who don't care about inmates," she said. "But inmates are human beings, and inmates go home. If effectively treated, they can lead organized lives, have families, have jobs and be taxpaying citizens. I think that we forget that."
Both the New Haven and the Bridgeport methadone maintenance programs are highly regulated and quite selective.
While just more than 360 inmates were accepted from the programs' respective beginnings through 2015, almost 800 were turned away.
In addition to already using and being in good standing with a methadone provider, offenders must satisfy a host of requirements to be selected, including having a sentence of one year or less, having a total bond of $50,000 or less, meeting set mental health, medical and discipline standards, and having an overall classification level that's not higher than 3.
Inside the program
Each day at 1 p.m. — with the exception of Sunday, when volunteers come in later in the day to administer methadone — 25 Bridgeport inmates file into a small, rectangular room with cages running along the longer walls and locked doors facing each other on the shorter ones.
Split into two groups, they line benches in each of the caged-in spaces, silently waiting for their turn to saunter up to the sliding, grated window in the corner — the only opening to the adjacent locked room and the methadone within.
Before and after the nurse inside hands each inmate his allotted dose of liquid methadone, staff shine flashlights into his mouth, checking to make sure he hasn't attempted to store some in his cheek to try to sell later.
"We manage it very carefully," Maurer said, noting that the main resistance among correction officials to adopting such a program typically is the safety aspect.
But in the New Haven and Bridgeport correctional centers, she said, officials have reported inmates in the program often are easier to manage than those who aren't.
"Based on feedback from the staff, there's a huge difference in the guys who are on the program and those who are not," Daniel agreed. "Our attitudes, the way we listen. We're able to step back. We don't get involved in fights. We know we have a lot to lose."
"Methadone gives me the ability to focus to think about why I'm here," said Jerome, a 44-year-old inmate from Meriden who spoke on the same condition as Daniel. "I feel like I could've done a lot for myself. But I understand where I'm at and all I can do is move forward."
A popular, star football player in high school, Jerome said he caved in to peer pressure and got into doing and eventually dealing drugs.
With convictions for crimes ranging from third-degree assault to second-degree larceny and sale of narcotics, Jerome is in a correctional center for the eighth time.
"But it's my first time in a methadone program," he said. "If I'd had that the first time, I wouldn't be back here for the eighth."
Daniel said his spiral into drug addiction began with a motorcycle accident that quickly was followed by an unrelated broken nose.
"It was one opportunity after another," Daniel said of the prescriptions he received for each incident.
Before he knew it, he was using heroin, hurting family and friends and garnering charges such as driving with a suspended license and failure to appear in court along the way.
Having also served 120 days for possession of narcotics in late 2012, Daniel is confident this stint in jail is his last.
"This is sober time," Daniel said. "Your brain can play a lot of tricks on you, but this makes you realize, I don't need any other drugs. It's a time of clarity."
A licensed electrician, Daniel said his fiancée, who's not a user, and a 15-month-old daughter are waiting for him at home.
"No more," he said definitively.
Always an important factor, the cost of maintaining and possibly expanding the methadone program is especially important in Connecticut, where budget cuts and layoffs across several state agencies have been making headlines for weeks.
In Bridgeport and New Haven, third-party groups — Recovery Network of Programs (RNP) in the former, the APT Foundation in the latter — keep the methadone flowing free of charge.
In Bridgeport, RNP Chief Executive Officer John Hamilton said the program costs his organization about $120,000 annually.
"It's the right thing to do," Hamilton said. "It's about recognizing that addiction is a health issue and those who are addicted should be treated like anyone else with a chronic disease."
"When someone with diabetes goes to prison, they don't lose access to their insulin," he added.
Plus, he said, the $4,000 to $8,000 it costs to treat one person with methadone per year pales in comparison to the $50,000 the state shells out per year per Department of Correction bed.
"It's a significant savings — let alone the toll on human life," Hamilton said.
Maurer said she knows finding organizations like RNP and APT in other areas likely won't be easy, but she maintains big goals regardless.
In addition to one day expanding the methadone maintenance program to Hartford Correctional Center, Maurer said she'd like to see methadone induction, which would allow inmates who aren't on methadone to begin taking it while incarcerated, in the state's facilities, too.
"The public may think this is a bad thing to do, but wouldn't you rather have people paying taxes than living in a prison or a jail?" she asked.