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Fifteen percent of Americans in jails and prisons have an opioid use disorder. Those those who undergo withdrawal and prolonged abstinence without treatment in custody face a 12-fold higher risk of death due to drug overdose in the two weeks following release.

Fifteen percent of Americans in jails and prisons have an opioid use disorder. Those those who undergo withdrawal and prolonged abstinence without treatment in custody face a 12-fold higher risk of death due to drug overdose in the two weeks following release.

Fifteen percent of Americans in jails and prisons have an opioid use disorder. Those those who undergo withdrawal and prolonged abstinence without treatment in custody face a 12-fold higher risk of death due to drug overdose in the two weeks following release.

Resources for the Justice-Involved

Medication for Addiction Treatment Program at the Santa Barbara County Jail

The Santa Barbara County Sheriff’s Office provides a Medications for Addiction Treatment (MAT) for individuals in custody at the Santa Barbara County Jail who are assessed as having an opioid use disorder. The MAT program focuses on treating substance use disorder through both a medical and clinical modality. Substance use disorder is a formal term for an addiction to drugs and/or alcohol. MAT uses medications along with counseling as a holistic approach to substance use disorder. MAT can help to stabilize the brain and help individuals control cravings and enable them to begin the long road to recovery. Here are the steps and components of the program:

Referral to the MAT Program

When a person enters custody and reports the use of opiates, they will be placed on a monitoring protocol to assess and manage the patient’s health while they are withdrawing. A referral to the program can be made by the intake nurse, any member of the mental health team, custody deputies and outside organizations such as public defenders or lawyers and probation officers. Once the withdrawal process is complete, The MAT Coordinator will then meet with and assess the patient for their readiness to accept treatment. At any time during their stay in custody a person desires to enroll into the program, they may personally submit a sick call request to be screened for the program.

Meeting with the MAT Coordinator

If the patient is ready to enroll into the program, they will complete a series of screenings including: a questionnaires regarding past substance use driven behavior and substance use history, a urine analysis, and a basic diagnostic lab panel. If the patient is accepted in to the program, they will be referred to a MAT Provider for their initial physical assessment.

Meeting with the MAT Provider

Physician writing a prescription for MAT

Prior to an in person meeting a provider, the patient’s labs will be reviewed to assess for medical stability to enter the program. Upon completion of the physical assessment, the MAT provider will determine which medication most appropriate to treat the patient’s substance use disorder. Continued monitoring of sobriety, by use of urine analysis will be implemented throughout enrollment in the program.

Continued Participation in the MAT Program

While enrolled in the program, patients will attend substance use disorder counseling. Based on the patient’s housing location, they may receive either a on a one to one or group counseling session. During these sessions, patients will discuss their substance use, their feelings surrounding the use, possible triggers, coping mechanisms, goals for maintaining sobriety, and much more. Participation in counseling is a requirement for continued enrollment in the MAT program.

Discharge from the Facility

Upon release from the facility, the patient will be provided with their follow up appointment at a substance use disorder clinic in their neighborhood and with a supply of medication to continue their treatment upon release. In some instances, the patient will receive an injection of the MAT medication prior to release. The patient will also receive signs and symptoms of opioid overdose, two doses of Narcan, and a list of additional resources for sobriety support.

To learn more about the Sheriff’s Department MAT program please contact Dr. Cherylynn Lee, Behavioral Sciences Manager.

Medications Used in the MAT Program

A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.

Methadone, buprenorphine, and naltrexone are used to treat opioid dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. People may safely take medications used in MAT for months, years, several years, or even a lifetime. Plans to stop a medication must always be discussed with a doctor.

Methadone

Methadone makes the brain think it is still getting the problem opioid, it prevents cravings and symptoms of withdrawal while reducing the risk of overdose. Side effects of Methadone include constipation, sexual problems, and swelling, sweating and potential heart problems.

Buprenorphine

Like methadone, buprenorphine suppresses and reduces cravings for the abused drug. It can come in a pill form or sublingual tablet that is placed under the tongue. Buprenorphine is a controlled substance that makes the brain think it is still receiving the problem opioid; it prevents cravings and symptoms of withdrawal while reducing the risk of overdose. Buprenorphine can only be prescribed by a trained provider that has an X- waivered license. Common side effects are headaches, nausea and constipation.

Naltrexone

Naltrexone works differently than methadone and buprenorphine in the treatment of opioid dependency. If a person using naltrexone relapses and uses the abused drug, naltrexone blocks the euphoric and sedative effects of the abused drug and prevents feelings of euphoria. Naltrexone blocks the effects of opioids but is not a controlled substance. It can be prescribed or administered at any health care or substance use disorder setting. Naltrexone is not recommended for pregnant women as detox can harm the baby. It is not known to cause any physical dependence.

Medications offered for substance use disorder is dependent upon your facility protocol; not all medications may be offered by the MAT program.

Restorative Justice and Diversion Efforts in Santa Barbara County

The Sheriff’s Behavioral Sciences Unit (BSU) was formed to oversee cases involving mental illness and substance use, develop a Crisis Intervention Team, and  build community partnerships to help adopt restorative justice principles to divert individuals from the criminal justice system and into treatment. You can learn more here.

Co-Response Teams for Mental Health and Substance Abuse Crisis

Co-Response Teams are a partnership between Sheriff’s Office and the Santa Barbara County Department of Behavioral Wellness. Each team is staffed with one trained deputy from the Sheriff’s Crisis Intervention Team and one licensed clinician from Behavioral Wellness. Teams are managed by Dr. Cherylynn Lee, BSU manager. The mission of the Co-Response Teams are to provide quicker and more comprehensive services to people in a mental health or substance use disorder crisis, to divert these individuals from the criminal justice system when safe and appropriate, and to provide connection and followup after the initial crisis contact.

There are three Co-Response Teams in the county, funded from a federal grant through 2022. Two teams operate in South Santa Barbara County six days a week and one team operates in the North County and Central Valley four days a week. People calling 911 for an incident they believe involves a person with a mental illness or a substance use disorder can request co-response, and if a team is available they will respond. Sheriff’s Deputies can request help from the Crisis Intervention Team (CIT) when they are on calls with persons in a mental health or substance use disorder crisis. The Sheriff’s Co-Response Teams also partner with co-response teams in the Santa Barbara and Santa Maria Police Departments and have joint weekly meetings and quarterly trainings.

In 2020 there were over 1,600 calls handled by one of the county’s Co-Response Teams; less than 15 of these cases ended in arrest to jail.

The Santa Barbara Sheriff's Office Crisis Intervention Team

Crisis Intervention Team Training for Law Enforcement

The Sheriff’s Office delivers a POST certified Crisis Intervention Team training and all local law enforcement agencies in Santa Barbara County have been trained including: Santa Barbara Police Department, Santa Maria Police Department, Lompoc Police Department, Alan Hancock Police Department, Airport Police Department, District Attorneys, Public Defenders, and Behavioral Wellness crisis staff. Over 1,000 officers in the county have received CIT training.

The Sherrif’s Office offers four different courses: an 8-hour patrol based course; a 40-hour patrol based academy; a 4-hour dispatcher course; and a 24-hour custody course. The Sheriff’s Office partners with: UCSB, the District Attorney, the Public Defender, the Probation Department, the Department of Behavioral Wellness, Wellpath, 911ATEASE, NAMI, YouthWell, Band of Brothers, and more.