The drug, called Vivitrol, is a monthly injection that is meant to block brain receptors in opioid-dependent people so they no longer are able to feel the dopamine-rush “high” when using opioids like heroin. Vivitrol is also intended to cut down on opioid cravings in patients over time.
The Ottawa County Jail has just implemented a Vivitrol program through its contracted jail health care provider, Correct Care Solutions.
To be enrolled in the Vivitrol program in Ottawa County, an inmate must sign up voluntarily, and not have used drugs in the past week. For the drug to continue to work, the individual must get an injection each month, a factor that may cause issues once the inmate is no longer incarcerated.
“The jail doctor will evaluate them and they have to be drug-free for 7-14 days,” Ottawa County Sheriff Steve Kempker said. “By the time they leave the jail, they will have qualified.”
Inmates that enroll in the Vivitrol program will receive an oral doasge of Naltrexone, a weaker derivative of Vivitrol, three days prior to their departure from jail. The next day, the inmate will receive their first injection of Vivitrol before they re-enter the community.
For the most part, these are individuals that have committed comparatively minor crimes, as individuals who are found guilty of felony offenses are turned over to state prison to serve longer sentences.
An injection of Vivitrol can be expensive, costing somewhere between $1,000 and $1,500 per monthly dose. For now, the manufacturer of Vivitrol will cover the cost of that first injection an inmate receives while in jail. After the inmate is released, however, it is their responsibility to follow up and continue with the dosages. There will be no cost to county taxpayers due to the jail offering the drug.
“Ottawa County is entering this program in partnership with Intercare Community Network,” said Jim Cheney, spokesperson for Correct Care Solutions. “After a patient leaves the facility, the medical staff at Ottawa County will coordinate future injections with Intercare. For Vivitrol to have its full effect, a patient will need to receive injections for about nine months. They have no financial responsibility, however, it is up to them to stick with the program.”
So far, no inmates have signed up for the program, but a few have expressed interest in taking the drug. Jail administrator Capt. Steve Baar has had inmates approach him about whether the program was available in the jail in the past, prompting the sheriff to begin offering the drug inside the jail.
Vivitrol does not help a patient detox, nor does it help treat withdrawal symptoms. Rather, the drug is meant to stop a patient from relapsing back into drug use after deciding to stop using opioids.
“Vivitrol is not utilized to ease the symptoms of addiction withdrawal,” Cheney said. “Its primary purpose is to negate the ‘high’ component of opioid drugs. In essence, a patient who has received Vivitrol injections will not have any euphoric experience should they decide to begin using again. You are basically blocking the drugs’ addictive qualities.”
While Vivitrol is being used in jails across the U.S., the drug carries several significant risks, including an increased potential for opioid overdose if a patient uses an opioid while also receiving Vivitrol injections. Because the point of Vivitrol is to help someone who has already detoxed, the person may have a much lower tolerance for the opioid than they did before. Additionally, some Vivitrol patients have tried to “beat” the brain receptor block and try to work around it by using significantly more of their chosen opioid than they have in the past. This behavior can lead to a potentially deadly overdose.
Other possible negative reactions to Vivitrol include sudden opioid withdrawal, severe reactions at the injection site, liver damage, depression, pneumonia and severe allergic reactions. On the other hand, Kempker hopes inmates that sign up for the program will be able to stay out of jail if they can follow through with the monthly injections.
“This is strictly voluntary,” Kempker said. “When they leave, they’re set up with a counselor and somebody that is going to monitor them. The risk is put on the person themselves. They know that it’s very easy for them to relapse, but some of it is the psychology part of it. In the long run, it does help a person that’s truly committed.
“If Vivitrol can be used to turn somebody’s life around, they can try and make that change in their life. We don’t want to see them coming back into our facility again. Hopefully we see a lowering in our return rate of inmates. The goal is to get them not to relapse.”
In a 2016 New England Journal of Medicine study of Vivitrol use in criminal justice populations, patients who received Vivitrol were able to go more than twice as long without relapsing into drug use than study participants who did not receive Vivitrol injections. Of those in the group that received Vivitrol, 43 percent experienced a relapse, compared to 64 percent of people relapsing in the group that did not get Vivitrol.
While the effectiveness of Vivitrol use in Ottawa County is yet to be determined as the program begins, the county’s jail medical provider is hopeful the injections will be able to begin to combat an increasingly common opioid problem for the county’s inmate population.
“We are very proud of the fact that the sheriff’s office has helped to facilitate this initiative, which can have positive and lasting impacts on our patient population,” Cheney said. “The ultimate goal (is) to help people remain drug-free upon release and stay out of the correctional environment.”