• Wednesday, December 16, 2020

• Juvenile Justice Programming

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RSAT Program Spotlight

A brief glimpse of some great RSAT programs

For the last six months, RSAT TTA has been reaching out to all currently funded jail and prison RSAT programs across the county and US territories to get the latest on what and how they are doing in these difficult times. Eventually, this section will include every program funded each year, but we don't want to wait to share with you descriptions of the exciting and diverse programs surveyed so far. Please check back soon for links to compendiums, including descriptions and contacts, of RSAT jail and prison programs by state.

If your program is not yet included, we will get to you. You can assist by contacting Steve Keller at skeller@ahpnet.com with your contact information and we will put you next on the list! Keep up your terrific work.

Our RSAT TTA website will also be displaying an interactive Google map of all RSAT-funded programs around the country. You will be able to search by program type, drug treatment offered and by special populations served. We hope this will serve as an informational networking tool for RSAT program directors, staff and grant administrators.

• Should Benzodiazepines and Opioids Be Used Concurrently?

  This examines the use of benzodiazepines for persons with OUD. The conclusion it is not safe, but there are exceptions.

• Heavy Drinking is Killing Women in Record Numbers, and Experts Fear a Coronavirus-Related Spike

  While alcohol-related deaths have risen by 51% from 1999 to 2017, there has been an 81% increase seen in women.

• Treatment of Stimulant Use Disorders

  SAMHSA's evidenced-based guide on treatment of stimulant use disorders published June 2020.

• Significant Changes in Drug Use During the Pandemic

  Since COVID-19 pandemic fentanyl and methamphetamine use is rising, heroin and cocaine falling.

• Buprenorphine, Suboxone and the Treatment of Opioid Use Disorder (OUD) in 2020

  This article focuses on buprenorphine in the treatment of opioid use disorder and offers a comprehensive overview of all forms of the medication. It provides updated links to information and research including phases of treatment, diversion and abuse of buprenorphine, length of time in treatment and detoxification, and barriers and stigma associated to access and treatment.

• Use of Codeine, Oxycodone, and Other Opioids: Information for Employees

  While making clear that current illegal drug use is not a covered disability, the US Equal Employment Opportunity Commission document clarifies that individuals who are lawfully using opioid medication, are in treatment for opioid addiction and are receiving Medication Assisted Treatment (MAT), or have recovered from their addiction, are protected from disability discrimination. In addition, the document answers questions about reasonable accommodations that may be available to employees who currently legally use opioids, as well as what to do if an employer has concerns about the employee’s ability to safely perform his or her job.

• AMA: Prescription opioids eclipsed by illicit drugs in US overdose epidemic

  Prescribed opioids are down, use of naloxone and PDMPs are up, but so is illicit opioid use, resulting in increasing OD deaths.

• Methadone Patients' Data Poised to Be Entered Into PDMPs

  SAMHSA now allows opioid treatment programs (OTPs) to put patient information into prescription drug monitoring programs (PDMPs). It will be up to each state whether this will be done. Persons on methadone maintenance should be alerted to ask if their data is being entered.

• Leaving Jail, Addicts Face a Growing Opioid Crisis During a Pandemic

  Describes the added challenges facing persons with substance use disorders upon release.

• AMA report shows overdose epidemic evolving, becoming deadlier

  Between 2015 and 2019, fentanyl OD deaths increased from 5,766 to 36,509, stimulants, like Methamphetamine, from 4,402 to 16,279, cocaine from 5,496 to 15,974 and heroin from 10,788 to 14,079. Prescription opioid ODs decreased from 12,269 to 11,904.

• Expanded access to treatment in prisons can reduce overdose deaths by more than 31%, study finds

  Based on the results of the MAT program in Rhode Island’s unified correctional system, study finds providing inmates and detainees with naltrexone, methadone or buprenorphine reduces post release OD deaths, especially for those previously incarcerated.

• Beneath Tragic New US Overdose Figures, There Are Wide Regional Variations

  ODs were up 4.9% in 2019. This article describes regional differences and theorizes that harm reduction strategies may account for them.

• New Peak of 71k US Overdose Deaths in 2019 Dashes Hopes

  Lest we forget, nearly 71,000 died of drug overdoses last year setting a new record that predates the COVID-19 crisis. The increase is attributed to fentanyl which accounted for more than half of the deaths according to the CDC. ODs went up in more than 30 states. A rare bright spot was declining OD rates in northeast credited to expanded treatment. We would also add active prison and jail medication-assisted treatment enrollments pioneered by the these states’ RSAT programs!

• Depot Antipsychotic Delays Hospitalization in Early-Stage Schizophrenia

  New research suggests that long acting injectable antipsychotic medication typically reserved for chronic illness should be considered earlier to avoid lapses in taking medication and need for hospitalization.

• Treatment of Stimulant Use Disorders

  The use of stimulants, Cocaine and Methamphetamine, is way up, including causing 40% of overdose deaths in 2018. This SAMHSA guide identifies evidence-based treatment, finding strong evidence for motivational interviewing, contingency management, community reinforcement approach, and cognitive behavioral therapy. The guide includes practice resources for each of these treatment approaches and examples and resources for evaluation and quality improvements.

• Resurgent Methamphetamine use at Treatment Admission in the United States

  Methamphetamine use has been on the rise and is linked to the increase in opioid use. By 2017, 50.4% of methamphetamine overdose deaths involved opioids, suggesting that the rise in methamphetamine-related harms is linked to the ongoing opioid overdose epidemic in the United States.

• Addicts at High Risk of Contracting Coronavirus

  Homeless, those sleeping in crowded shelters or people with other health conditions — such as hepatitis C, HIV or lung disease — are high risk, said Dr. Daniel Solomon, an infectious disease physician who works at the Brigham Health Bridge Clinic for patients with substance use disorders. For recovering addicts, anxiety about COVID-19 can have a “triggering effect” that can lead to relapse, said James McKowen, a psychologist and clinical director of the Addiction Recovery Management Service at Massachusetts General Hospital, which is moving toward treatment via telemedicine, phone calls and group-based video conferencing to reduce the risk of transmission.

• SAMHSA Letter to Mental Health Commissioners

  ALERT! SAMHSA clarified that state Community Mental Health Services Block Grants (MHBG) can be used for the care and treatment of incarcerated persons with serious mental illness in prison and jail. RSAT programs serving persons with co-occurring mental illness might qualified for this funding.

• Naloxone Videos You Can Use

  Here are some helpful videos on Naloxone administration. The first is for Law Enforcement Roll Call, the next is Instructions for Administering NARCAN, and the last is whole series of short videos on Naloxone Training & Education.

• Promising Practices Archive

Additional RSAT Guides & References

Introduction to Trauma and Trauma-Informed Approaches for RSAT Staff

Preventing, Detecting and Treating HIV/AIDS and Viral Hepatitis: Health Promotion and Risk/Harm Reduction in Substance Abuse Treatment

A Comprehensive Listing of What States Cover for Substance Use Disorder, including Medications

New Manual on
Health Literacy

Once they obtain health coverage, RSAT participants need to maximize the benefits offered in terms of preventive and primary care to promote both better physical and behavioral health.

Recent Medication-Assisted Treatment Studies Relevant to Corrections

"A Rehab Jail for Heroin Addicts" in Franklin County Massachusetts

Franklin County and the Greenfield, Massachusetts community addresses the opioid crisis with an innovative approach to treatment. The Franklin County Jail is one of the only corrections facilities in the country offering suboxone to its clients.

RSAT Jail Program Tour

What Inmates Tell us About RSAT