Erik Lamoreau, a Substance Use Disorder Peer Recovery Center Manager at Roads to Recovery, speaks with former Speaker of the House Sara Gideon about substance use recovery and stigma during an Aug. 27, 2020, roundtable discussion at the Caribou Wellness and Recreation Center. Credit: Chris Bouchard / Aroostook Republican

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HOULTON, Maine — One of the best places to intervene in the opioid epidemic is at the exit doors of jails and prisons.

Aroostook County Jail is launching a pilot program to give a naloxone kit, naloxone training and opioid recovery resources to every person leaving incarceration. Sheriff Shawn Gillen and organizers at Aroostook Mental Health Center are targeting January 2022 to begin the project.

The initiative is funded by a $1 million federal grant to combat substance use disorder stigma and prevent overdose deaths. The U.S. Health Resources and Services Administration awarded the grant to the AMHC last month.

Jails are a vulnerable spot in the battle against substance use disorder. Somewhere between a quarter and 40 percent of the people who died of overdose in Aroostook County this year had been incarcerated at the jail, AMHC Project Coordinator Erik Lamoreau said. Distributing these kits could be a huge step in the right direction for The County.

“We’re trying to stop deaths,” Lamoreau said. “We’re on the downslide and the street drugs are not getting safer. It is a priority, not only for us as an organization and a community, but as the state and nationally — to try to get naloxone into as many people’s hands as possible.”

Naloxone is something of a miracle drug — it can completely halt and reverse the effects of an opioid overdose in a matter of seconds, and most people can be trained to administer it safely.

Aroostook County Jail had already been distributing naloxone to people who had participated in their suboxone treatment program while incarcerated — a specific type of medication-assisted treatment for people with opioid addictions. But those people only account for a small fraction of the total number of inmates struggling with substance use disorder in Maine’s jails and prisons.

Roughly a quarter of people incarcerated in Aroostook County are part of the suboxone program, specifically, according to Gillen, but somewhere between 65 and 80 percent of people incarcerated in the state report addictions to alcohol or other drugs.

Not only is the jail one of the most concentrated populations in The County of people dealing with substance use disorder, but the days immediately following a person’s release from jail are some of the most dangerous when it comes to overdose.

It takes as little as three days for opioid tolerance to begin to wane. Even people who spend just a weekend in jail are at an increased risk for overdose upon release.

That’s why between five and eight of the 19 people who died of overdose between January and August of this year were former inmates, Lamoreau said. It’s difficult to isolate the exact number because that data isn’t tracked by any one organization, he said.

Rather than ask people to disclose their substance use disorder upon exiting the jail to receive the medicine, AMHC and Gillen’s office decided that giving naloxone to everyone was a much safer bet.

Not only is it more streamlined this way, but naloxone is equally useful in the hands of someone without substance use disorder as someone battling opioid addiction themselves. You can rarely administer naloxone to yourself, Lamoreau pointed out.

“They may be in a house where somebody may need it,” Gillen said. “That could potentially save a life.”

In addition to the naloxone itself, people leaving the jail will also receive fentanyl test strips, a packet of local recovery resources and an overdose intervention training administered by guards.

Part of the grant money will go toward training corrections officers in how to teach people to use naloxone. This is a huge deal for Gillen, because over the past decade, law enforcement has become the first line of intervention in Maine’s addiction and mental health crises.

“It’s stressing our capabilities at the jail and in law enforcement too,” Gillen said. “It’s pushing us in directions that we’re not trained in. There’s not enough resources right now. There’s not enough places to put somebody that’s in need of a mental health facility, so a lot of times our law enforcement and our corrections officers are forced to be that mental health crisis worker.”

As opioid overdoses become more common, naloxone and naloxone training are becoming more practical for everyone, Lamoreau said. Most people know somebody who is battling substance use disorder and roughly 20 percent of all Americans have lost someone to opioid overdose.

Local organizations like Roads to Recovery in Caribou and Aroostook Recovery Center of Hope in Presque Isle provide free naloxone and walk-in naloxone training to anybody who asks for it, no questions asked. But some people, particularly those who have already gone to jail for their substance use disorder, may not feel empowered to reach out.

That’s why the new naloxone distribution program at Aroostook County Jail will save lives, Lamoreau said.

“The laws aren’t going to change about people going to jail as quickly as we can change interventions and programs to help lower that mortality rate post release,” Lamoreau said.

Hannah Catlin

Hannah Catlin is a reporter at the St. John Valley Times/Fiddlehead Focus in Madawaska, Maine.