Buncombe plans in-jail opioid treatment program

Buncombe County Detention Facility
UNLOCKING TREATMENT: The Buncombe County Sheriff's Office plans to greatly expand the use of medication-assisted treatment for inmates with opioid addiction at the county jail. Photo courtesy of Buncombe County

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.

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About Daniel Walton
Daniel Walton is the Green Scene editor and a reporter for Mountain Xpress. His work has previously appeared in Capital at Play, Edible Asheville, and the Citizen-Times, among other area publications. Follow me @DanielWWalton

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12 thoughts on “Buncombe plans in-jail opioid treatment program

  1. Richard B.

    Finally, an opioid treatment program that makes a lot of sense. Congrats to Ms. Gayton and all who are sponsoring and supporting this practical, common sense program.
    Why common sense? These addicted folks are getting an opportunity to save their lives by virtue of being incarcerated, where they are do not have access to drugs.
    In makes all kinds of sense to provide every opportunity for them to get treatment while they are a captive audience, not dependent on their will power to avoid relapse.

    My 28 year old nephew is alive because, after his second break in, the judge finally gave him a two year sentence. This is NY State, and while in jail he was involved with group therapy and MAT, which is standard procedure for those requesting the program. He was released to a day recovery treatment program after one year, part of the Parole Agreement. He is working, attending groups and therapy, and no relapse after 18 months.
    Three years ago, a few months prior to his desperate attempt to steal funds for more drugs, he was about gone when my sister found him with barely a pulse in the bathroom when she returned home from work. A passing deputy sheriff, seeing the door open, stopped and administered Narcan, saving his life.
    My sister credits the Judge and the Program for her son still being alive. There is no guarantee of relapse, but forced abstinence and a sensible program has provided a new lease on life. No question.
    Mr. Fryar is well intentioned with his concern for efficacy in spending tax payer dollars, and he has my full support to continue his efforts in this regard.
    However, this is one funding effort that I believe many informed tax payers are willing to support.

  2. luther blissett

    “It’s plain and simple: We can’t change them.”

    Even taking Mr Fryar’s moralistic opinion at face value — the evidence doesn’t support it — what’s his alternative? Hope that they die in ditches or end up in state prison?

    Supervised opioid withdrawal treatment works. It can be done in jail relatively easily. The choice not to do so is based upon the idea that prisoners ought to go through cold-turkey detox as part of their punishment.

    https://www.washingtonpost.com/graphics/2019/national/fentanyl-epidemic-trump-administration/

    • M. Meadows

      Sounds good, but bill the prisoner not the taxpayer. Let them pay for the cost of their own addiction. Not the taxpayers. The choice to get clean is the right one, but knowing you can do it anytime by simply getting locked up isn’t sustainable. Nor should the county, state, or federal government reward horrible personal responsibility by footing the treatment cost. Own your choices. Stop rewarding bad behavior.

      • notsamuelljackson

        Ask the thousands and thousands of parents who have lost their children to opioids if treatment is “rewarding bad behavior”. Good kids whose deaths began by taking a pill, possibly prescribed for pain by a dentist or physician. And if we had a health system in place that wasn’t driven by corporate GREED, maybe more of these poor folks could afford to seek treatment outside of jail. What a country…..

        • M. Meadows

          What a country….sure is when everyone else is to blame. Not everyone who takes a pill becomes an addict. When everyone else is at fault for stupid choices and must be burdened with the cost of rehabilitation, you’re right, what a country. Assuming every addict that ends up in jail/prison is a “poor folk” is pretty daft as well. If you run fast enough, responsibility will never catch up.

          • luther blissett

            “Not everyone who takes a pill becomes an addict. ”

            True. But given that family studies show propensity to addiction running in families or tied to environmental factors, the “stupid choices” / “personal responsibility” line of thinking has to extend to the choices of parents and grandparents and local government and school administrators for it to hold up.

            https://www.drugabuse.gov/publications/drugfacts/genetics-epigenetics-addiction

      • luther blissett

        “knowing you can do it anytime by simply getting locked up isn’t sustainable.”

        That’s a strawman. Cut the moralistic claptrap, educate yourself on addiction, and rejoin the real world. The custodial system in the US already serves as a surrogate welfare / health / mental health system that middle-class white folks are willing to pay for when they’re unwilling to fund the same services outside of incarceration.

        • M. Meadows

          Thanks luther for your two cents. The revolving door of incarceration/addiction/treatment is well established. On your highroad you couldn’t see my point. All drugs should be legal and taxed. The monies raised by said taxes would more than fund education, prevention, and addiction services. It would also slow down the growth of this countries profiteering criminal justice system. It has worked on a limited basis in other countries, but you know that already.

          Big problems need big solutions. But instead of solving these and other issues we use band-aids, duct tape, and chewing gum. When people live in small boxes all they see is small problems.

          • Lulz

            LOL say how are you going to collect from cartels? They are afraid of the LAW? Especially with an open border lulz..

        • Vicki

          Nicely stated, Luther. Education of people who don’t understand addiction is of paramount importance when seeking support for tax payer funded treatment. After all the science surrounding the fact that addiction is a brain disease, it appears folks like M Meadows haven’t gotten that message yet.

  3. Vicki

    Nicely stated, Luther. It seems with all the science surrounding addiction there are still folks who need to be educated on it. Addiction is a brain disease and requires treatment, long term treatment. The brain can take up to 10 years to heal from opioid addiction. Two week stays at treatment facilities do nothing but detox and provide a short reprieve in a safe environment. I support Suboxone treatment and hope my tax dollars save a few lives- well worth the cost. As for “choice” to take drugs and become addicted, I can assure M.Meadows that no one chooses that h*ll. There’s a simple Chinese saying that sums it all up. “A man takes a drink. The drink takes a drink. The drink takes the man”.

    • M. Meadows

      I support tax and legalization. My education and experience suit my needs nicely, thank you. Good luck funding a 10 year treatment plan. To take any drug is a “choice”. To claim anything else is a flat-out untruth, or alternative fact. The science surrounding addiction….you support a pharmaceutical solution to a pharmaceutical problem. Critical thinking is dead.

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