Prisons around the country are trying new methods to help inmates battle drug and alcohol addiction and to reduce recidivism. At the Barnstable County Correctional Facility in Massachusetts, those who choose to participate receive a once-monthly injection of Vivitrol, a long-acting form of the drug naltrexone. Injections are administered just prior to the inmates’ releases and at follow-up visits in the subsequent months.
Naltrexone is a non-addictive drug that helps to reduce cravings for alcohol and opioids. It was approved by the FDA in 2006 for the treatment of alcoholism and works by blocking opioid receptors in the brain, blunting the pleasurable effects of alcohol and opioid drugs.
Three years into the Barnstable County program, which includes counseling, housing assistance, job placement and a link to outpatient care, the results are encouraging. A reported 70 percent of participants noted a drop in their cravings, and 78 percent appeared for their first post-release shot. About 40 percent have remained in treatment, or completed Vivitrol use and remained sober.
Recidivism has dropped concurrently. In 2014, Barnstable released data showing that out of more than 100 inmates who went through their Vivitrol program, 21 percent have been re-incarcerated, which is far below the national average of nearly 70 percent of inmates returning to jail within three years of release.
Currently, Vivitrol programs, which offer inmates monthly shots of the drug along with counseling and other support after their release, are available in about 40 states.
In Maryland, inmates from the Washington County Detention Center have participated in a Vivitrol program run by the Washington County Health Department. In the first three years of the program, 83 people were given monthly shots. Of the 83, only two drank alcohol or used illegal drugs while receiving the shots.
While Vivitrol is expensive (around $1000 per shot) and far from a silver bullet, it is non-addictive and can give people time to establish new habits and cope with underlying issues. Most experts recommend that participants continue to receive the injections for approximately one year. Medicaid or Medicare often help pay for treatment. Vivitrol has been shown to work best when it is part of a holistic program that includes counseling and support.
“Naltrexone buys you a month, but if you stop taking it and you haven’t developed coping strategies, you may relapse,” said H. Westley Clark, a retired former director in the Substance Abuse and Mental Health Services Administration, in a Washington Post article.