July 2022 NACo Annual Conference Workshop Summary

“A disproportionate number of people in jail have substance use disorders and communities have a responsibility [and] legal obligation to provide treatment.” – Meg Chapman, Policy Advisor, U.S. Department of Justice, Bureau of Justice Assistance 

County and justice leaders play a key role in implementing strategies and local programs to reduce the impact of opioid and other substance misuse within the community and criminal legal system. Nearly 63 percent of individuals who are incarcerated in jails live with substance use disorders compared to five percent of the general population.[1] People with opioid use disorders are three to eight times more likely to overdose after being released from incarceration.[2] The U.S. Department of Justice’s Comprehensive Opioid Stimulant and Substance Abuse Program (COSSAP) demonstration projects began in 2018 to support local innovation and strengthen federal understanding of effective local responses towards substance use disorders. The 2022 NACo Annual Conference featured a workshop on Supporting People with Opioid Use Disorders that featured speakers from Memorial Regional Health in Northwest Colorado, Pitt County, N.C. and the U.S. Department of Justice. Speakers shared evidence-based strategies to prevent substance misuse and support community members living with opioid use disorders who are involved in the criminal legal system.

A Rural Response to the Opioid Epidemic
Memorial Regional Health, Northwest Colo.

Memorial Regional Health (MRH) serves five pioneer counties in Northwest Colorado (Moffat, Rio Blanco, Grand, Jackson and Routt) and is one of 21 COSSAP Rural Responses to the Opioid Epidemic (RROE) planning sites addressing opioid and other substance misuse in the community. Nicole Shatz, RROE project coordinator with Memorial Regional Health, highlighted the health center’s three tiers of activities to support individuals with opioid use disorders.

• In Tier 1, the Overdose Fatality Review team, a multi-disciplinary team of public safety, public health and government agencies, looks at individual cases to identify system barriers and gaps in treatment and services that result in overdose deaths. The team uses this information to make recommendations for innovative community overdose prevention and intervention strategies for individuals at risk of overdose.
• Tier 2 involves the Community Overdose Prevention and First Responder Support programs that focus on educational opportunities and first responder trainings for nonviolent crisis interventions. The Community Overdose Prevention team utilizes a school-based youth prevention program—Grand Futures Prevention Coalition—to provide education on tobacco, marijuana and other drugs, overdose awareness training, positive youth development opportunities, naloxone (e.g., Narcan®) training and youth mental health awareness training. The team also has implemented year-round medication drop off locations and disseminated harm reduction kits to promote medication safety, use and storage. In addition, MRH’s First Responder Support program partners with the Crisis Prevention Institute (CPI) to offer nonviolent crisis intervention training, as well as mental health and trauma support for first responders in the five-county region.
• Tier 3 offers recovery support for people involved in the criminal legal system. A Recovery Support Team provides case management for on-going recovery and re-entry services and provides monthly “Clean and Sober” events for community members. The 14th Judicial District Adult Diversion Program is referral-based and provides similar services; however, it focuses on diverting individuals from interacting with jail systems. The diversion program had its first graduate in May 2022.

Jail-Based Programing
Pitt County, N.C.

The Pitt County Sheriff’s Office utilized a COSSAP grant to build a workforce of program coordinators, social workers and jail navigators to serve people in jail who have opioid and other substance use disorders. Kierra Clemmons, Clinical Social Worker at the Sheriff’s Office, discussed the Sheriff’s Heroin Addiction Recovery Program (SHARP) and Women's Empowerment and Recovery Program (WEAR). Read more about these programs in NACo’s County News.

Guidelines For Managing Substance Use Withdrawal in Jails
U.S. Department of Justice, Bureau of Justice Assistance and National Institute of Corrections

Meg Chapman, BJA Policy Advisor, and Stephen Amos, Chief of the NIC Jails Division, highlighted a forthcoming resource on supporting people with substance use disorders in jails, which is scheduled for release in Fall 2022. The resource will provide guidelines for jail protocols, policies or programs – such as MAT – to support people with substance use disorders. BJA plans to offer funding opportunities for counties in the future to implement these guidelines.

This blog was supported by Grant No. 2017-AR-BX-K003 awarded to the Institute for Intergovernmental Research (IIR) by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice’s Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of IIR or of the U.S Department of Justice.

[1] Bronson, Jennifer, Jessica Stroop, Stephanie Zimmer, and Marcus Berzofsky, Revised 2020, “Drug Use, Dependence, and Abuse Among State Prisoners and Jail Confined Persons, 2007–2009,” Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, https://bjs.ojp.gov/content/pub/pdf/dudaspji0709.pdf.

[2] Elizabeth Merrall et al., “Meta-analysis of drug-related deaths soon after release from prison.” Addiction 105(9) (2010): 1525-1554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955973/.