Two Bridges Regional Jail started its medication-assisted treatment and reentry program the week of Aug. 12 with 10 inmates.
State funds cover each inmate’s participation for a full year. The funds cover the in-jail portion of treatment as well as support through reentry into society.
Maine received $2.3 million in federal money to target opioid addiction and contracted Enso Recovery to implement a medication-assisted treatment program in county jails.
Enso Recovery currently works with three Maine jails: Kennebec County Jail, Two Bridges, and York County Jail.
The CEO of Enso Recovery is local activist and businessman Timothy Cheney, perhaps better known to locals as the owner of Clark’s Cove Farm & Inn, the apple orchard and wedding venue in Walpole.
Inmates will finish the in-jail portion of the program in a month to eight weeks.
The inmate may then choose a recovery house to live in, according to Cheney. Enso Recovery owns four recovery houses, two in Augusta and two in Sanford, with one for women and one for men in each location.
“We have the recovery houses to offer a structured, safe living environment for people transitioning into early recovery,” Cheney said. “Most people who come in need a place to go when they come out.”
Others who have “stable housing with people that are not using drugs, nothing to jeopardize their recovery,” may choose to go there, he said.
Those inmates will remain in treatment with Enso and will go to outpatient clinics and continue to take medication if prescribed.
At this time, Two Bridges Regional Jail has funding for 16 beds in the program, according to Col. James Bailey, the administrator of the jail.
“I anticipate that number to climb within the next couple of weeks,” Maj. William Frith, assistant administrator of the jail, said.
At the outset of the program, Enso Recovery reviewed the jail population to determine eligibility for screening. It has since instituted a process for screening incoming inmates within 72 hours of admission.
According to Cheney, an inmate undergoes a 30-minute initial screening that looks at the inmate’s background, substance use, and motivation for treatment to determine whether the program is appropriate. After the initial screening, an inmate undergoes a 1 1/2- to two-hour clinical interview.
Induction is on a case-by-case basis.
“’Violent offenders’ is a tricky term with substance use, because the lifestyle associated with addiction is often violent,” Cheney said.
“We are not going to blindly discriminate” based on charges, he said.
The screenings began before August and are ongoing, Bailey said.
It is easy to identify some inmates with addiction. “Others aren’t so easy,” Bailey said.
Many inmates who are in jail for something other than a drug charge or conviction are nonetheless addicted.
“The real goal is to be able to segregate the inmates in the (medication-assisted treatment) program from the rest of the general population. … Where we are at right now, it is becoming a little bit difficult, because the area that I have is a minimum security housing area for the 16 beds,” Bailey said.
At this time, medium-security inmates who otherwise qualify for the program cannot be separated from the general population, although they can take the classes.
Inmates in the program are in a classroom five days a week for three hours a day. They have a break every hour and have to complete some exercises on their own.
During the classes, inmates learn to adjust their thinking about opioids and gain life skills, such as how to write a resume and answer questions about a criminal charge in a job interview.
The inmates learn about the neuroscience behind addiction, relapse prevention, and much more, Cheney said.
“Once you come out of there, you’re not the same person as you were when you went in there,” Cheney said of the in-jail classes.
Bailey selected four officers to staff the program and hopes to grow the number as the program expands.
According to Cheney, Enso ran a first responder recovery coach training for corrections officers that serves as an “abbreviated curriculum of the full recovery coach training.” A recovery coach is a nationwide professional designation for people who help others throughout the recovery process.
Recovery coaches “help (inmates) get through the typical obstacles that sometimes result in relapse in early recovery,” Cheney said.
The next step is to have all the program staff, the assistant jail administrator, and Bailey become certified recovery coaches.
Enso Recovery has one full-time staff person who performs screenings and leads the programming, along with clinicians who come to the jail, according to Bailey.
About 90% of inmates in the program will be prescribed medication for opioid use disorder, such as Suboxone or Vivitrol, Cheney said. Some will take the medication longer than others.
“Some people down the road will no longer need it, and some people will need it,” Cheney said. “And that’s their choice, and what works best for them.”
Once an inmate leaves the in-jail portion of the program, he or she will go to one of the recovery houses unless they have other safe housing. The recovery houses have clinical staff, case managers, and recovery coaches to help with ongoing treatment.
“We like people to not go back to their original environment because that’s where they were using drugs. There are a lot of triggers,” Cheney said.
General assistance helps to pay for a person to live in a recovery house for a few months.
“After they are on it for a couple of months, they are expected to work and pay a sliding scale for rent,” Cheney said. The money goes to recovery house upkeep.
At the Sanford location, the most rent Enso charges per person, per month is $500, Cheney said.
Every inmate has a treatment plan upon release and Enso Recovery will work with treatment providers to ensure a continuum of care. Local service providers, such as Mid Coast Hospital’s Addiction Resource Center in Damariscotta, may assist inmates with continuing treatment and help them get insurance, find housing, and look for a job.
The program’s biggest challenge thus far has been changing the mindset of jail staff, Bailey said.
“Corrections is often known for locking people up and we watch over them, that’s it,” Bailey said. “It’s not about rehabilitation; it’s not about reentry; it’s safety and security, which is important. But what I tell my own staff is, all these individuals that we see in this jail, they’re our neighbors, they are in the community, and they are going to get out eventually. So why not try to help them stay out?”
The second-biggest hurdle is the funding for the program. Although the state has the federal grant, it does not pay for the jail to staff the program.
Bailey would like to quadruple the program’s size.
“My hope is that we can secure more funding, either through grants, the state, or a combination of both,” he said.
Bailey has heard a lot of support from the staff, the Lincoln County district attorney, and the inmates themselves, who are “extremely excited” about the program.
Cheney is enthusiastic to see the program in his county and the local jail. Now a successful entrepreneur, Cheney was once addicted to heroin and living on the streets of New York City.
“It’s my community, it’s an ideal venue, and they have a progressive staff,” Cheney said of the jail.
“It’s raising the awareness, eliminating the stigma, reintegrating people into their communities, and hopefully changing the perception of addictive disorders to a health care issue, not a criminal or moral issue,” Cheney said about the new program.