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Friday, July 3, 2020

Whatcom County Jail to treat inmates with opioid use disorder

Photo by Matt Pearson

By Ian Ferguson

The Whatcom County Jail will begin implementing an opioid addiction treatment program to inmates who are addicted to opiate-based drugs. The program was finalized in a settlement agreement over a civil lawsuit between the American Civil Liberties Union and Whatcom County Jail.  

On June 6, 2018, the ACLU filed a class-action lawsuit against the Whatcom County Sheriff’s Office for denying inmates with opioid use disorder — a disability acknowledged and protected by the Americans with Disabilities Act — their medication, according to court documents.

While the sheriff’s office said they were developing the program prior to the lawsuit, the ACLU claimed their policy of refusing treatment was illegal.

Over the past year, Whatcom County and the ACLU have worked to develop a proper program and have come to a settlement, which was signed by all parties on April 26, according to the settlement document. The settlement is now awaiting approval by the court.

A report by ACLU said the settlement is the first class-action lawsuit that has resulted in a jail changing it’s entire policy to provide a treatment plan to all individuals diagnosed with opioid use disorder.

According to a report by the sheriff’s office, the medication assisted treatment program, referred to as MAT, has three phases, two of which have already been implemented.

Bill Elfo, the Whatcom County sheriff, said the first phase began in September of 2018 and intends to help inmates who are experiencing the physical symptoms of opioid withdrawal — using drugs to slowly taper them off opiates and diminish the withdrawal period.

The second phase allows patients who were already on a treatment program prior to their incarceration to continue with their program while incarcerated, Elfo said. This phase began in February, 2019.

He said that while the first two phases are still in their beginning stages, the impact of their implementation has not been substantial. This is primarily because there isn’t a large pool of people that are medically qualified for the programs.

Elfo said the third phase is where they hope to see the greatest impact.

Elfo said the final phase will begin in about five weeks and will give willing inmates the means to begin a treatment program while incarcerated. This is intended to aid inmates with opioid use disorder into a lasting recovery.  

“Phase three is where we really want to see the progress of being able to connect with people and hopefully get them out of the criminal justice system,” Elfo said.

The lawsuit in 2018 was filed by the ACLU on behalf of two inmates who were denied access to medication for Opioid Use Disorder, according to an ACLU report.

The report says because opioid use disorder is acknowledged and protected by the Americans with Disabilities Act, the Whatcom County Jail policy of refusing medication was illegal.

“Singling out a group of people because of their disability and denying them access to medical services to which they would otherwise be entitled is prohibited under the Americans with Disabilities Act,” the ACLU stated.

Elfo said the Sheriff’s office have been working on a MAT program since 2016, nearly two years prior to the lawsuit. He said it was a “pioneering activity,” at the time there was not a clear set of protocols established to easily adopt and implement a MAT program.

He said they received a small grant to study what successful MAT programs around the country looked like.

There were two main hurdles in the process, Elfo said. The first was the lack of community based MAT programs in Whatcom County. He said they were hesitant about treating people in jail only to release them with no option to continue treatment.

Now, with the implementation of phase three close on the horizon, Whatcom County has several community based treatment programs, Elfo said.

The second issue was the jail itself, he said. The drugs used with MAT — primarily Suboxone — have a high potential for abuse.

“People use it to get high,” Elfo said. “It happens all the time.”

Because of this, detoxing inmates have to be observed closely and must be held separately from other inmates. He said the jail did not have the adequate space to implement this.

“We believe it’s an illness, addiction, and we want to be able to treat it better, and get people out of the criminal justice system and into the treatment system,” Elfo said.

According to the Centers for Disease Control and Prevention, two thirds of all drug overdoses in the U.S. involve an opioid based drug. The number of drug overdoses from opioids was nearly six times higher in 2017 than in 1999.

In a 2017 report,  the Whatcom County Medical Examiner found that 26 people had died of overdoses — most resulted from mixing opioids with other drugs like methamphetamine, cocaine and alcohol.

“Whatcom County has been suffering from the opioid epidemic, just like the rest of Washington and our nation,” Elfo said in a report. “MAT helps people manage their addiction and saves lives.”



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