New program in jail to treat opioid addiction

Nowhere in the county is the scope of the opioid abuse problem more evident than in the Island County jail.

Medical professionals who work there estimate that 70 to 80 percent of inmates suffer from opioid addiction.

A new program, however, offers hope to inmates who want to stop using. It’s called medication-assisted treatment, or MAT. Under the jail program, addicted inmates who want to participate are given the drug suboxone, an opioid antagonist, during their last five days of incarceration and are set up to continue using the drug, as well as get into counseling, at the Didgwalic Wellness Center in Anacortes.

The program is the brainchild of the medical director for the Island County jail and juvenile detention center, Yvette Fletcher (formerly Esparza). She is a fervent advocate for inmates suffering from addiction and has worked months to set up the unique program to help them. She is an advanced registered nurse practitioner and contracts with the county to provide medical services in the two facilities.

“I’ve developed an emotional attachment to the jail,” she said. “I’ve grown connected to the people in jail because they all have a story.”

Suboxone has widely replaced methadone as a treatment for opioid addiction. The drug counteracts the effect of opioids and prevents the user from getting high. It contains buprenorphine, a partial opioid antagonist, and naloxone, a opioid antagonist used to treat overdoses. Officials who run Island County Drug Court have found it to be an effective treatment option, they said.

The jail program, which just started this month, is advertised with posters and literature in the jail. Four inmates signed up to participate on the first day.

Jail Chief Jose Briones said he completely supports the program, even though it comes with a “minimal cost.”

“My philosophy is, ‘Let’s not warehouse people,’” he said. “Let’s treat people when we have them here.”

Fletcher said she learned from working in the jail how widespread the opioid addiction problem is on the island and how it’s connected to crime.

“If we’re going to reduce crime on the island we need to address the issue of opioid addiction,” she said.

Fletcher first came to the jail to do an assessment of the medical-related practices after the 2015 death of inmate Keaton Farris from dehydration.

Then county officials asked her to implement her suggested changes, which included such things as a protocol to help inmates going through drug or alcohol withdrawal. Then she won a three-year contract with the county to be the medical director of the facilities.

“I’m basically everyone’s primary care provider,” she said.

She said she went online and worked to receive a “buprenorphine waiver” that allows her to prescribe certain drugs, including suboxone. She wasn’t sure what she was going to do with the waiver at first but realized she had an opportunity to help addicted people in jail.

“They get clean in the jail,” she said. “It’s like they’re a different person in a couple of weeks.”

Her next project is to get a treatment facility in Oak Harbor so that people released from jail on the suboxone program — and other island residents suffering from addiction — don’t have to travel off island for treatment. She found resistance, however, from providers on the island; she is currently the only one with a waiver to prescribe suboxone.

“They didn’t want to deal with that population,” she said of the other providers.

Yet she’s been in contact with providers in Oak Harbor she hopes will get on board with MAT. There’s federal funding that may become available for the providers to treat people who have opioid addiction.

“I’m not going to be able to save the world,” she said. “One patient at a time is good enough for me.”

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