Countermeasures Season 2 Episode 1 Podcast Transcript: Improving Outcomes in Jails and Prisons
Chris Chavez [00:00:00] In the court systems, it’s also amazing. I mean, I can share an experience where an individual was very upset. He was yelling at the judge, she was ready to arrest him. It was just not a good situation in general. And he started yelling and saying, you guys don’t know what it’s like, you don’t know how it feels. And I ask judges, can I go talk to him outside real quick? And I went and I talked to him. He says, no, you don’t get it. He’s like, I’m losing my kids. I’m doing this. And I was able to share with them. I said I had two kids that were adopted by my their grandparents because I was incarcerated. I’ve had to go through these struggles. I struggle with this. I didn’t have this opportunity either. I went straight to incarceration and didn’t get a chance to get out and prove myself to anybody. I need to get a chance to get out and do classes and comply with the DCS stuff. And I didn’t even have that option. And once he seen that, he seen that there was this whole other side in that it wasn’t set in stone, you know, and it wasn’t even that he trusted me. It was just that he was able to build that rapport with me real quick and say, okay, I need to I need to not be like this guy. And it was enough to where I think that it brought him to a place where he was willing.
Narration [00:01:16] This is Countermeasures brought to you by Emergent, maker of NARCAN® Nasal Spray. Join us as we explore the shifting complex world of the opioid crisis. Today, opioid overdose is a leading cause of accidental death, with so many families, loved ones, and friends behind these lives lost. This season, we’ll continue to explore some of the communities hit the hardest by the crisis, from prisons and construction sites to schools and elderly care. We will hear from changemakers offering a new way forward. Navigating the criminal justice system can be difficult for anyone. For those who struggle with opioid use or those who are in recovery, these challenges can become even greater. According to the National Institute on Drug Abuse, 65 percent of the prison population in the United States may have a substance use disorder. These challenges continue following release as well. Previously incarcerated individuals, or at least 40 to 129 times as likely to die from a drug overdose compared to the general public two weeks following their release. More can be done to support these populations. In this episode, we explore some of the organizations and individuals who are helping influence the system and facilitating recovery and support for incarcerated individuals, as well as continued support upon their release.
Jason Edgcomb [00:02:47] Yeah. So my name is Jason Edgecomb. I’m the jail superintendent at the LaSalle County Jail in Illinois. We’re about a mile or an hour and a half from Chicago. Right on Interstate 80. Got here just through, I’ve been doing this job for 14 years now, and in those 14 years, we’ve had some of our medical doctors who also treated people with substance use disorder on the outside. So they came to us and wanted to see what we could do for people in the facility, because they were seeing a lot of roll over, and the people they were seeing on the outside. We’re also coming back in here, and being then sitting in the jail without any sort of treatment. So that’s how we got to where we’re at.
Narration [00:03:30] LaSalle County Jail is one of the jails across the United States that has MAT or Medication Assisted Treatment, sometimes also called Medication Assisted Recovery, available in the jail. Originally, Jason didn’t understand the importance of these kinds of programs.
Jason Edgcomb [00:03:47] So the origin of this program was the doctor coming in. He worked at other facilities in Wisconsin and Michigan, some jails that did MAT services in those facilities. And he wanted to start doing them here. I knew nothing about it. I had a lot of faith in him, and I, and I kind of chuckled one day and just said, hey, whatever you want to do, I’m giving you free reign to do it. He could see that that was just me going along with it. So he came in and sat down with me and and that wasn’t good enough for him. He wanted me to understand it. Probably the most telling thing that he ever said to me, and you hear this a lot along all the circuits is people with SUD, you like to look at him and treat him like somebody who was maybe a diabetic. Just because they come to jail, you don’t stop giving them their medications, you don’t stop treating the diabetes. And just because someone comes to jail, we shouldn’t stop treating the disease of their substance use. So that kind of was a little bit of an eye opener for me. So when I looked at it and then that’s when I really started doing some more research on my own, talking more with him about it, talking to other people about it, and really trying to get involved with the community of people that offer help for people with substance use disorder.
Narration [00:05:02] Jason emphasizes that the medication has only one part of treatment. Resources like peer support, one on one, and group counseling and education are all critical parts of the path to recovery.
Jason Edgcomb [00:05:15] Yeah. So the I think that the easiest way to say that when you talk about the medications and a MAT/MAR program is that it’s only one part of the program, right? There’s not a medication that fixes anything. A big part of that is we highly recommend counseling people in our recovery, that they can sit down with our mental health provider. And, you know, maybe there’s a triggering effect for them that causes them to relapse or causes them to want to use. They can address that they have somebody in their life to address that with. Upon release, we do the same thing and we try to get them into that, get them set up with the counselor on the outside. If they’re not comfortable in an AA setting, because in AA setting isn’t for everybody. You know, some people don’t do well in a 12 step. It’s important for us to find them that smart recovery, another avenue of some kind of be able to get them the the support that they need with those people. So the medication itself is a great first step. We have people that feel good on it. Again, when we talk about my sister, you could see the difference in her on a daily basis. So the great thing about the medications is it gives us that opportunity to get their head clear, so then we can work with them through all of the other aspects, to try to keep on that on the right path.
Narration [00:06:32] Chris Chavez, who you heard at the top of this episode, is the regional manager of community programs at HOPE Incorporated. HOPE is a peer and family run organization that offers support for people living with a mental illness or substance use disorder, as well as those in the criminal justice system. After being released from jail, Chris got a job at HOPE incorporated, where he has used his lived experience to help others.
Jason Edgcomb [00:06:58] I basically came into this field not knowing what I was doing. I had previously gotten in a lot of trouble. I was on probation the majority of my adult life. I worked only two jobs my entire life, so I worked at the same construction company and then I worked at HOPE. That’s it. And I was working construction. I did all my stuff. I got my life turned around, and I decided that I did not want to go back into the construction world. And so I went to some employment services. And when I went to them, they were trying to give me a job, but we were really struggling. Like with my background, I couldn’t get employment anywhere. I was just it was very difficult process. It was very frustrating. And my, you know, my case manager at the time, said, why don’t you become a peer support? I didn’t know what it was. I just said, okay, I just I just knew I wanted to do anything but go back to that construction life. So they got me my peer support certification. I applied everywhere. It was very discouraging because everywhere wanted a year experience, but I didn’t know how to get a year experience if I couldn’t get a job. So HOPE actually hired me. But they hired me as an admin assistant and so I started as an admin assistant. No clue what I was doing, just answering phones. Thank you for calling HOPE. This is Chris. And it was it was a very humbling experience. It was very different from what I’ve ever experienced. And so I kind of just went through and as I started learning and I started helping people. I started realizing how many aspects there are to the behavioral health world and to be able to help so many people through those avenues. Even with volunteering and everything else that I I’ve learned and I’ve adapted in my life, it’s, and it’s become a part of my recovery. And once I took off, I took off, I became a peer support, then a then in case manager, case manager to program manager. And now I’m a regional manager. So once I once I got a taste for it, I couldn’t stop.
Narration [00:08:59] Both in his role at HOPE Incorporated and from his own experience, Chris knows that there are a lot of barriers to someone getting the treatment and help they need to be successful in recovery and reentering society.
Jason Edgcomb [00:09:10] Some of the biggest barriers for incarcerated individuals, I think, is the treatment while they’re still incarcerated. There’s not a whole lot of programing. There’s not a whole lot of treatment. There’s you know, I really wish there could be more peers co-located in the jails so that they could offer services in groups in in helping them to assist with resources when they get out. Because even for myself, one of the biggest resource deficiencies that I faced was financial. Because even if you get arrested and you go in and it’s for 30 days, you know, have 30 days of bills and 30 days of no income, and it’s more likely that you’re going to go in [00:09:50]recidivate [0.0s] than to go out and try to figure it out the right way, because it’s very difficult. It’s very frustrating. It is hard even when you’re in there and you’re trying to call people, you’re trying to figure it out. Like even in my situation, I had money in my bank, but I couldn’t pay the bills because nobody had access to my money. So even though and then I got all these [00:10:13]leaf [0.0s] and everything and it just stacked up and it just set me back so far. And we encountered that a lot with these individuals. And it’s really sad that, you know, they, they end up using some sort of a substance. They get violated. They get sent to jail. They have to wait for a review hearing. Then they go to the hearing and then by the time they get out now, they’re just further behind than if they would have just got them into treatments or or offered them other assistance or resources while incarcerated to help them when they get out to not face those issues.
Narration [00:10:49] Olivia Sugarman is a postdoctoral fellow at Johns Hopkins Bloomberg School of Public Health, where she works in the Department of Health Policy and Management with a group called the Bloomberg Overdose Prevention Initiative. Olivia says that programs like the one run at LaSalle County Jail are the exception, not the norm. She also highlights some of the barriers that people who are reentering society face.
Olivia Sugarman [00:11:13] Let’s break it down two ways. So incarceration can mean a couple things. There’s incarceration in jail and incarceration in prison. And the difference between the two is important. So jail is pretty short term. So different states have different policies about who can be in jail. So usually it’s people who are waiting for a trial. That can be a period of months. That can be several months. It can be a few days. Other people in jails might be people who have been sentenced, but their sentences are about a year, 18 months. Whereas people who are in prison have been sentenced, their sentences are a little longer. So that’s the difference. So from a health perspective, think of, okay, incarceration, the period that you’re in a facility is kind of this catchment period. So what’s happening while you’re incarcerated with your health is kind of a black box, period. We’ll just leave it at that. So thinking of social determinants of health for reentry. So we don’t really know what’s happened while you’ve been incarcerated. Who knows if you’ve gotten preventative health. For people who use drugs, that could mean a period of abstinence without any kind of treatment. That conversation is changing. But that’s kind of been the predominant idea, is that people usually don’t get treatment while they’re incarcerated. So thinking about social determinants of health on the re-entry side. So say you get out as a blanket statement. Most of my work so far has been in prisons. So my slant is a little bit more there. But housing generally is huge, period. Like if you’re getting out of prison, like you haven’t been connected to broader society for a long time, where are you going to stay? Generally, you get out of prison, you get on in maybe 20 bucks in a bus ticket, or at least that’s the story in some places. What are the other supports available to you when you get out? So housing is one. Employment’s another big one. There was this big campaign around banning the box of, disclosing that you have have some kind of criminal record, whether or not that affects whether you get employed. And then, of course, your sustaining, I mean, so many things are tied to employment. Can you buy food? Can you continue paying for rent? Do you have health insurance? Are you able to afford health insurance if it’s not from your employer? That’s a big one. And then the third one, I would say, and this is less policy and maybe less concrete, but it connections to people and positive connections to people. So do you have family nearby who have some kind of housing option for you, so you can stay with them for some time, like people to help you get back on your feet and take care of some of the more tangible social determinants of health so you can be supported longer term.
Narration [00:13:46] Having strong, comprehensive support while incarcerated can make a huge difference in helping to set people up for success.
Jason Edgcomb [00:13:53] You know, we’ve had a couple of success stories through here. One of them, I think that really has affected me the most was we had a young girl that was coming in here. She got into the program. She my whole career she’d been coming in here, always with drugs, always having a terrible opioid problem. And she came in this time and she was looking at prison time and, and she got into this program and she kept waiting for a bed. And I don’t understand what, I never will understand what the way it was. But we had other people come and go. That facility’s accepted and they just never accepted her. So she was waiting and waiting. But the whole time she’s waiting, she’s doing all this recovery stuff and everything else. And I’m pushing the states attorney’s office, and I’m telling them, listen, she really needs drug court. Let’s keep her here. She’s doing so well. Let’s do this. And I couldn’t convince the state’s attorney’s office not to send her to prison. And then when the time finally came, I didn’t want her to find out about it in court. So I went down, and I talked to her one on one, and I looked at her and I said, I’m sorry. You know, I feel like I failed you. You’re working your rear end off to your sobriety. You know, I can’t get you in drug court as much as I’m trying. And she said, that’s okay. I’ve accepted the fact that I’m going to prison. And she says, you know, they’re they’re looking at eight years, but she says, you know, every time I’ve been to prison, they’ve always offered us programs for treatment. And I’ve never once taken one of them. And she says, I’m going to prison this time with a clear mindset, and I’m going to take every single class that they give me. And, I said, well, that’s great. I said that, but I just wish they would understand that, you know, you’re finally understanding your sobriety and that we can help you if we keep you here. I said, I just feel like I let you down. And she looked me in the eye and she says, there’s no way you let me down. She says, this has been the most life changing experience I’ve ever had. And she says, because of this, I’m going to go to prison. I’m going to continue to try to get better. She did a six year prison stint and 16 months because of everything she did when she went to the Department of Corrections. She got involved in everything. We went to a training class that had some counselors from the Department of Corrections there. They knew her by name, and they told me that she was amazing, and she came in with such a great attitude to her recovery. So I, you know, I think back on that one because it’s it shows that you can make a difference to people while they’re sitting here waiting for everything, no matter what the outcome is. Right? It doesn’t have to be a happy ending of them getting out of the county jail and going home. She had that right mindset that was, it doesn’t matter what happens to me now. I have a full future that try to change and look out for.
Olivia Sugarman [00:16:53] A lot of people in prison in jail have a substance use disorder of some kind of opioids or otherwise, but they don’t really receive treatment. Like health care received in carceral settings, it’s a whole other can of worms. I wanted to see what clinical what do you clinical trials have to say? How many have been done if any? What do they show us? And do they include things like social determinants of health. So and some of those interventions did. So in addition to providing and not even just medications for opioid use disorder, so things like peer counseling. I think a couple of them included naloxone training, which is what’s to the point of treatment, but rather overdose prevention. And basically what I found was people acknowledge that social determinants of health are important, but none of the interventions really included those explicitly. So there’s some work to be done. At the same time, and I’ll say this, it’s hard to include those, it’s a lot to include for one person at one time. People need a lot when you’ve essentially interrupted their lives for potentially decades, and then you’re trying to get them back on your feet. Like things move so quickly anymore. Even five years, it’s a long time to be away and try to reestablish yourself, especially when you have an untreated underlying brain disease like substance use disorder, and you’re trying to establish yourself.
Narration [00:18:10] While there are great results like those shared by Jason, there are still no universal standards of care for treatment for someone struggling with opioid dependency while incarcerated. It is up to management, like Jason, to decide what programs are included.
Olivia Sugarman [00:18:24] There are standards of care for the general population that are enforceable in a lot of different ways. Those enforcements generally don’t exist in carceral facilities, so a lot of people will say this Estelle v. Gamble Case that went through in the 70s, that essentially says that you have to provide medical care for people who are incarcerated, because not providing adequate medical care is construed as cruel and unusual punishment. And that’s kind of that. There is there’s federal policy, and there are internal policies that exist that require you to go through X, Y, and Z steps to make sure that people’s health care is taken care of. Those exist and I don’t want to negate that does exist. But as far as what’s enforceable, what’s measurable, what’s overseeable, it’s kind of up in the air, and a lot of it goes to the States and sometimes can be as granular as the in the individual facility. And in some ways, relies a lot on whoever the warden is or whoever’s running it. Like, what is their general sense around the acceptability of opioid use disorder treatment and opioid use disorder in general? Like how do they think about that question? The minimum is never the maximum. We’ll put it that way. I don’t know that there’s necessarily a cap on what people can offer there. So Maryland has just as an example, some states are passing policies that require jail facilities to offer each kind of opioid or a medication for opioid use disorder. That looks a lot of different ways. And working with someone now who is evaluating that policy and how the rollout is going. So that’s one way of ensuring that medications are made available. And again, medication is not the only option for some people. Some people prefer not to use medication. That’s fine. But there are peer support programs, I think, in [00:20:05]ANA going places [0.0s] like that. So that’s one way of doing it. Other facilities can elect to do it themselves. There’s not really a standard of care, but as the drug supply is changing. So I’ll acknowledge the fentanyl continues to dominate the drug supply. Then also just kind of it’s important to acknowledge people’s choices and giving them choices, even in a controlled environment like incarceration.
Narration [00:20:29] Olivia hopes to see the continuum of care outside of jail and prison improve to further increase chances of continued success after reentry.
Olivia Sugarman [00:20:37] I think it’s an important consideration, and I think it goes back to getting some kind of treatment while people are incarcerated. So in that paper that I wrote, the consensus from all those clinical trials was essentially start soon after you get in and stay out as long as you need to, and make sure that there are some kind of warm handoff on the other end. And I think that’s the biggest piece I know. I’ll be bold in saying it’s not rocket science, that we have demonstrated this over and over again. If people have continuity of care, that’s helpful. One policy that makes me hopeful, it’s very new and it’s hard to say how effective it will be because it just happens. So there are these things called 1115 waivers for Medicaid. So basically what states can do is apply for some kind of exemption from Medicaid policy. It has to be budget neutral. And I wouldn’t say it breaks the rules, but it might bend the rules of some policy that Medicaid has around either how much they’ll reimburse for something or whether they’ll cover something. There’s something called the Medicaid inmate exclusion policy within broader Medicaid legislation, which basically says Medicaid won’t pay for service, won’t pay for services for people who are incarcerated while they’re incarcerated, except for hospital stays. It’s like the the one asterisk. There’s a new round alone, 15 waivers going out that will allow states to cover, I think it’s up 30 days or more of health care costs reimbursable by Medicaid before people get out. That has a lot of promise for coverage. Generally, I think it has a lot of promise for warm handoffs. I mean, the jury’s still kind of out on whether or not those will be effective.
Narration [00:22:19] She also hopes education improves to help lower the risk of overdose upon re-entry.
Olivia Sugarman [00:22:25] Everybody’s at risk. So opioid naivety is a big issue. Knowing what’s in your drugs, knowing what you’re using, having the tools to combat something if you do or don’t know what’s in your drugs. So again, kind of the distinguish or the difference between being in jail and being in prison. So if you’re in jail, say you’re in for a week, you know, you’ve had some let’s pretend, let’s just play through the scenario. So say you’re in jail for like a week. You’re don’t have access to medications for opioid use disorder if that’s what you want to use. So then your tolerance is a little lower. You come back out. You might be more familiar with what’s in the drug supply. So like you might know what to look for. So it’s kind of a toss up, like, you use, you know what’s in your drugs, but your tolerance might be different. So that puts you at higher risk for overdose. From jail or if you’re in prison for a certain amount of time, say, a couple of years, you’ve been totally in this scenario, you’ve been away from drugs and using drugs for a long time. You don’t know what’s in the drug supply anymore. You haven’t been exposed to all these other things. You don’t have the information available to you. You use. Don’t have the tools. And then also put you higher risk for overdose. Also not people use drugs in jails and prisons. Like I don’t want to be naive about it. Like those still get in there, but do you have access to the same tools you would in the community if you had all the information, and if you had all of the resources available to you? Not necessarily. So, yes, there is a higher risk of overdose after release from incarceration for a myriad of reasons. The drug supply is also generally just very dangerous right now, and giving people information and harm reduction tools is really important.
Narration [00:24:17] Another barrier for people with opioid dependency is navigating the criminal justice system.
Jason Edgcomb [00:24:22] I think there’s always going to be a struggle between participants in the court system, because a lot of the times, even including myself, like I felt like I was a victim of the court system. It wasn’t my crime that got me there. It was the court system that they did it to me. And we see that a lot now. And even just the perspectives of you think when you’re incarcerated in a prison, the CEOs are on the opposite side. Right. And and that’s something that I like to share a lot at that parole orientation is I say it’s not a game of cat and mouse anymore. You’re you’re not behind the fence. You’re on the other side. Like, our goal is to keep you out. And I let them know, because now that I’ve worked with some of these people, I don’t know, like they don’t want to do all the paperwork. It takes more paperwork to write a word for you than it does if you’re just doing good. And the POs want you to do good. Pretrial offices wants you to do good because it’s less work for them, and it’s better for the community. And getting them to see the other side of that and to see that, that they don’t want to do that extra work, I think, is a way that they relate to, and it helps to break down that barrier of that it’s not them just trying to be out to get them into right that warrant and that it’s okay to call and ask questions. It’s okay to utilize us as peers to ask those questions, to utilize our relationship with parole, to to ask those questions or even the court systems. We drive a lot of people to courses and we educate people on them. We let them know, like, hey, this isn’t what that court’s about. This is this court. This is we know this judge. We know these people. So a lot of the times it’s us using our reports with the member to bridge with the rapport that we have with the courts.
Narration [00:26:01] Chris also uses his experience to help decision makers understand the issues facing people in prison and when navigating the criminal justice system.
Jason Edgcomb [00:26:10] It’s amazing how my background applies to so many different things in so many aspects. So like even the simplest things like the construction or the substance use, or the incarceration or the the full continuum of all of it, it’s it’s just some it’s being able to utilize those aspects when needed and, and being able to to share it when it applies. Because I’ve noticed, too, that, you know, people that are oversharing or it’s giving too much sometimes you can take away from the point we’re trying to get across. And it’s simple things like they could, the best example I can give you is when I was part of the Pinal County and they were saying, oh, we want to do these the screening systems, and we’re going to screen for substance use and we’re going to do this. And I said, who’s going to do those screenings? And they said, oh, we’ll have a CO do it. And I said, so when I was in your jail, I said, I wouldn’t even tell the nurse that I was using because I was afraid that it was going to be held against me when I went to court. So I’m far less going to be able to tell a CO how I truly feel in the struggles I’m truly facing and it needs to be somebody that’s not a part of that system, because they can flip. So like being able to give that insight of how it is when you’re in there, giving insight of of what the programing is, like, when sometimes when I hear some of these, you’ll say, oh yeah, we have programing here. And being able to say, okay, so what’s the capacity of that programing? Oh 30 people. So you’re telling me you have a thousand people in your jail in 30 year programing? You know, and it’s like bringing that that insight because it was a struggle for me. When I was in there, and, and you want to sign up for classes or you want to go to an even an NA meeting or, you know, to church, it’s a very short list of the people that are available to go. It was almost like, it made me feel like I wasn’t even good enough in there. If I couldn’t even make the list to go somewhere. I wasn’t available to go, because I had it reached that seniority in there to to make it. And so I think the bringing those aspects to a lot of these meetings and sharing how it made me feel when I was in there using my lived experience is probably the best part of the the whole job.
Narration [00:28:24] Peer support and navigating the court system is another key to helping people be successful.
Jason Edgcomb [00:28:29] Peer support is amazing in the aspect that we’re not another provider. We’re not there to work with you. We’re like, especially at our agency, we don’t drug test. We are not there to report to the courts everything the members doing. And we make this clear to the courts as well, that they were there to advocate for the member. We are not there to report for the member. We’re not there to drug test for probation. We’re not there to do home visits for probation. Well, we do with our member is our business. And the only time that we’re mandated to report is if they’re in danger to themselves or others. And it’s nice because the courts also see the effectiveness behind that, because then the members can can trust us. Because you think if you were to put yourself in their shoes and they’ve already felt like like we talked about the, the discretions between the court and the members and that that mistrust and then that they don’t really understand this new court system or this whatever to the new parole, because they could change their name and being able to really educate them and show them that is very different than just telling them to, if you know what I mean. So it’s like it’s it’s really just educating both parties of what our role is and making that role clear that it’s for the member and we’re there for them. Because if they were to tell us, hey, I went and used and then they go to court and they’re like, hey, we heard you used. Then they’re like, oh, I’m not telling that guy ever again, you know. And so we want to be that support. We want to encourage them. Hey, you should tell the judge, you should call your your appeal and let them know that you messed up. And this is what we’re going to do about it. We’re going to make a plan. And this is for your this is best for you. So that if you do at the drop and it comes up, it’s not like you got caught. It’s you were honest in the beginning. And educating them, kind of how that all works.
Narration [00:30:27] Jason believes that the criminal justice system needs to find a better approach to help people be successful. But he’s hopeful for the future.
Jason Edgcomb [00:30:34] When we talk about obstacles to this, I would think that the biggest obstacle is communication with the justice system. You know, you’re trying to help people. And yes, we do get some people in here who are just using the system to try to manipulate their court case. But such as a young lady, we get some people that are sincere in trying to better their lives and turn things around. You know, early on in all of this, when we actually had inmates in custody, we would have people that we’re trying to help and we’re trying to get set up, and all of a sudden they’d go to court one day and they’d come down from court, say, no, I got time served today, and our nurse has no time to get up any of our discharge planning stuff ready, and I’d have to work with the State’s attorney’s office and say, hey, listen, you guys told me that you weren’t going to do anything with this for, like, another two months. While we offered or something today, and they took the time served. We offered him this. He took the time served. So we’re letting him out. So you’re not doing them any justice. You’re not doing us any justice. We can’t get them the services to continue on. So we’ve worked a little bit on that. But that’s been a huge obstacle for us, is just having that communication so that people don’t just, you know, as we talked about earlier with the overdose straight out of custody, right. If we don’t get them out the door, Narcan, if we don’t get them any services, they go out right away. And you, we may never get them back in again. And that’s what we want to try to avoid. So that’s, that’s probably our biggest obstacle to not being able to see all these people upon release because we don’t know they’re getting released so quickly. As far as the corrections industry and these programs, I think that the corrections industry is behind the eight ball on this, but I think they’re starting to catch up. We do work here in Illinois with HMA, who sponsors a lot of jails and does a lot of work with jails doing this type of recovery. And HMA is also they do work in California and other in other areas. They’re currently getting ready to go and do a project in Michigan for the same stuff. So I do think we’re trending in the right direction. But of course, it would have been great if we could have been trending this way before everybody recognizes this opioid epidemic, right? But now that it’s here, now that, you know, we’ve lost so many people to it already, now we look and see. We have to react to it. So, you know, I think that we’re starting to catch up. Every year I go to the American Correctional Association conference, and every year there’s more and more training MAT/MAR. First year I went was probably in 2014. There was I didn’t see a single class on it. We went to Orlando a year ago, February, and I bet you there was at least a dozen different classes on MAT/MAR and in correctional facility. So, it’s starting to grow and you’re starting to see more and more of that, which is a good thing.
Narration [00:33:27] The corrections industry is one of the places where the most support is needed for people seeking recovery, but where there is inconsistency and care, for the most part, it is dependent on individuals and management to decide what programs will be available at the facilities. Both while incarcerated and after release, access to services and peer support can make a huge difference in the lives of people seeking support and recovery. Organizations like HOPE that offer services and advocate for their members are a critical component of driving this industry in the right direction. Formerly incarcerated individuals are also at greater risk of overdose once released for a wide variety of reasons, including decreased tolerance and a changing drug supply. Jails and prisons across the country are beginning to provide naloxone to people upon release, but it’s not a universal policy, and many barriers exist. Researchers like Olivia are working to understand how to better support this community. Programs like the one that is run at LaSalle County Jail, and organizations like HOPE Incorporated, are all steps in the right direction. Thank you for listening to this episode of Countermeasures. To learn more about what Emergent is doing to help address public health challenges like the opioid crisis, visit emergentbiosolutions.com. If this episode resonated with you, consider rating and reviewing Countermeasures on your preferred podcast platform.