Jill Schramm/MDN Dr. Stephanie Gravning with the Department of Corrections & Rehabilitation speaks to the Ward County Commission Tuesday about opioid treatment in correctional facilities.

Studies show positive results when inmates receive treatment for opioid use disorder while incarcerated, according to a physician with the North Dakota Department of Corrections & Rehabilitation.

Dr. Stephanie Gravning, health authority for DOCR, spoke to the Ward County Commission Tuesday about the treatment program at the state penitentiary.

“What we do at the state level would be very, very beneficial also at the county level,” she said. “It’s an expensive program. But the expense of not having a program like this is greater. So, the effects of substance abuse are wide ranging, and they affect people of all ages. It’s not just the addiction itself. It’s the other complications that come from it, such as HIV, Hepatitis C, chronic heart disease, cancer. It’s all linked to homelessness, crime and violence. And so, combined costs for the individual and society as a whole is estimated at about $525 billion, including healthcare, lost productivity, accidents and other costs.”

Ward County has banked about $90,000 so far from participation in a class action lawsuit against companies that have manufactured and marketed opioid medications. The county’s opioid task force is developing a plan to use the funds to initiate a program to provide opioid use disorder treatment during incarceration. Currently, inmates who enter the jail can continue an existing medication treatment but there is no mechanism for them to start treatment.

“It’s one thing to continue it but we can do better,” Gravning said. “We can do better by helping to facilitate people getting into those programs when they’re in that controlled situation.”

In its program, DOCR can obtain a mandate through the court requiring a prisoner undergo treatment. DOCR’s preferred medication, Sublocade, is administered by injection once every 28 days.

“We began this in prison because there’s dozens of studies that show this can reduce illicit opioid use after people are released. It reduces criminal behavior post incarceration. It reduces mortality. It reduces overdose risk,” Gravning said. She also cited a Rhode Island Department of Corrections study showing that starting treatment while incarcerated significantly increased ongoing compliance after release, compared to starting treatment at release.

Medication stabilizes a prisoner by controlling withdrawals and cravings so that addiction counseling then becomes effective, Gravning said.

Many jails don’t offer medication treatment because of the cost. Medical costs of inmates are a responsibility of the county jails. No North Dakota county jail offers Sublocade.

“The reason they are not using the Sublocade is because it is cost prohibitive. It’s about $1,400 per injection. That is an expense that is covered by Medicaid, though, after people are released from incarceration,” Gravning said.

The value of medication treatment was impressed upon the commission by a former inmate now in recovery, who serves as a peer support specialist for a recovery program and is employed in the community. “Samantha” said she continues to take methadone, which she started almost two years ago to address her opioid use disorder.

“My life was in a perpetual cycle of addiction, arrest and desperation. The cravings for drugs consumed every moment,” she said. “However, since embarking on the methadone program, my entire existence has been reshaped for the better.”

She said allowing individuals to receive medication therapy within the jail system can be a beacon of hope.

“The stability and support offered by the methadone program have been instrumental in guiding me toward a life of sobriety and fulfillment,” she said. “Each day, I wake up with purpose and goals, relish in the opportunity to help others and make a positive impact on the world.”