In the fight against an ever-worsening epidemic of opioid addiction and overdoses — one of Buncombe County’s six strategic priorities — jails are on the front lines, according to Sarah Gayton, detention programs director for the county Sheriff’s Office. At a May 21 meeting of the Board of Commissioners, she unveiled a plan for the Buncombe County Detention Facility to address the root of the problem while inmates with addiction are in custody through medication-assisted treatment.
In a MAT program, patients with an addiction disorder receive controlled doses of medication, such as naltrexone or buprenorphine, in conjunction with counseling and therapy to help them avoid returning to more dangerous substances such as heroin or fentanyl. While the Buncombe jail offers this treatment to pregnant females with opioid addiction, Gayton explained, it’s not currently an option for other inmates. Even those on a MAT regimen when admitted to the facility, she said, are instead placed into detox.
“We’ve got not only the rhetorical captive audience, but we have a population at high readiness for change,” Gayton said as she advocated expanding the use of MAT. Without intervention, she added, opioid users are at a 40% higher risk of overdose in the month after their release from jail.
Gayton noted that, although the treatment is considered a science-based best practice for opioid use disorder, only 11 county jails across the country currently have a “robust” MAT program; in North Carolina, pilot programs have been tested in Rutherford and Forsyth counties. She said that the state Department of Health and Human Services has identified seed money to support a full year of program development and that county staff are in “dynamic” negotiations to secure the funding.
However, Gayton did not present that amount or discuss how the program would be funded beyond its first year. Commissioner Mike Fryar said he was concerned that county taxpayers would pick up the tab once state grant money ran out; he also expressed skepticism about the value of the treatment.
“We can’t stand in here and make everybody in this county safe,” Fryar said. “You have to look at the reality. You’ve got drug addicts, you’ve got drunks, you’ve got alcoholics. It’s plain and simple: We can’t change them.”
“I would totally disagree with what was just said,” responded Brownie Newman, the commission’s chair. “This is one of the hardest issues that we face as a community and a society, but I think to just throw up your hands and say we can’t do anything is not the right approach.”
Other members of the commission also shared their support of the proposed initiative. Jasmine Beach-Ferrara said that county staff members were working “to bring hope and opportunity for healing and recovery,” while Al Whitesides argued that failing to support treatment efforts would cost more over the long run.
“We have a fiduciary responsibility as commissioners to represent the people of Buncombe County, our constituents,” Whitesides said. “When I look at the figures of how many people we’re losing, and I talk to EMS personnel here in the county and they tell me how many calls they have because of the opioids — these are sick people. We can’t afford not to help them.”
Edited 4:48 p.m. May 24 to accurately reflect the status of previous MAT programs in North Carolina.