NCCHC and NSA Issue Guidelines to Assist Jails in Treating Inmates With Substance Use Disorder

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By The National Commission on Correctional Health Care & The National Sheriffs’ Association

Published: 10/29/2018

Jails are on the front lines of the opioid epidemic in the United States—and they also are in a unique position to save lives by initiating treatment for incarcerated individuals with substance use disorder.

The National Commission on Correctional Health Care and the National Sheriffs’ Association are pleased to present a resource to support sheriffs and their jail administrators in providing effective treatment in a controlled, safe environment. Jail-Based Medication-Assisted Treatment: Promising Practices, Guidelines, and Resources for the Field was developed to guide jails in developing MAT programs. MAT is a cornerstone of best practice for recovery, and treatment using MAT, particularly when coupled with evidence-based behavioral treatment, improves medical and mental health outcomes and reduces relapses and recidivism.

The document introduces what has been learned from sheriffs’ and jail administrators’ innovative use of MAT to date, describes the essential components of these programs and discusses the latest research on how the programs are best implemented, as well as the medications approved for opioid use disorders. Key features are as follows:

An overview of general tenets and best practices associated with developing, implementing and sustaining a jail-based MAT program. This outline of key issues and questions is well-suited for a quick read by criminal justice executives.
A deeper exploration of the topics highlighted in the overview, including existing standards, related guidelines and examples from the field. This section delves into technical details and may be most appropriate for MAT program developers and hands-on practitioners.
The Programs in Action section provides a window into several real-world, jail-based MAT programs, including outcomes and lessons learned.
Throughout the report are tools, treatment programs, references and supporting documentation.

Specific topics examined in the Best Practices and Guidelines section range from client enrollment to postrelease considerations, which are crucial in helping to ensure continuation of treatment.

Client enrollment in a jail-based MAT program
The correct medication, dosage, and length of treatment determined for a client in MAT
MAT for pregnant women
Medication alone is not the answer: The force multiplier of partnerships and support services
MAT program components: Assembling the right team, safeguards, protocols and structure for a successful jail-based program
The importance of client screening to address treatment continuation, withdrawal and relapse
Engaging Medicaid and postrelease financial assistance

Despite the increasing evidence and formal support from many prominent public health and public safety organizations, substance use treatment providers—both inside and outside of the criminal justice system—have been slow to add MAT. However, close to 200 jails are known to provide at least limited MAT (for pregnant women, for example). The Promising Practices, Guidelines, and Resources document profiles five successful jail-based MAT programs that can serve as models for others:

Louisville Metro Department of Corrections, Kentucky
Middlesex Jail and House of Correction, Massachusetts
Rhode Island Department of Corrections
Sacramento County Jail, California
Snohomish County Jail, Washington

A Collaborative Effort Promising Practices, Guidelines, and Resources is the result of an extraordinary collaboration of federal, national and private partners. The inception of this project was a February 2017 roundtable discussion with representatives from several federal agencies, model MAT programs in criminal justice and correctional settings, professional associations and organizations involved in policy, research and training.

ABOUT THE NATIONAL COMMISSION ON CORRECTIONAL HEALTH CARE
NCCHC is a not-for-profit 501(c)(3) organization working to improve the quality of care in our nation’s jails, prisons, and juvenile detention and confinement facilities. NCCHC establishes standards for health services in correctional facilities, operates a voluntary accreditation program for institutions that meet these standards, produces and disseminates resource publications, offers a quality review program, conducts educational trainings and conferences, and offers a certification program for correctional health professionals. NCCHC is supported by the major national organizations representing the fields of health, law and corrections. www.ncchc.org

ABOUT THE NATIONAL SHERIFFS’ ASSOCIATION
Chartered in 1940, the National Sheriffs’ Association is a professional association dedicated to serving the Office of Sheriff and its affiliates. NSA represents thousands of sheriffs and deputies in our nation’s 3,300 jails, as well as other law enforcement and public safety professionals and concerned citizens nationwide. Guided by a board of directors and 17 committees, NSA addresses the full range of issues of importance to law enforcement in fulfillment of its mission to support and enhance the professionalism of those whose job it is to serve and protect. It provides its 20,000-plus members with a wide range of services, information, trainings and technical assistance, including a professional magazine, an e-newsletter and an annual and winter conference. www.sheriffs.org

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