Anne Arundel sees success with jailhouse methadone program ; County sees success with jailhouse methadone program [Maryland Gazette (MD)]

For Casey Hendricks, being high on prescription drugs was such a euphoric feeling. It seemed like endless freedom to her, and gave her boundless energy. Nothing else in this world mattered.

"I liked that," said Hendricks, sitting in a room at the Ordnance Road Correctional Center in Glen Burnie. "It was a different high than I'd ever felt before."

A certified dental assistant in 2003, Hendricks was prescribed Oxycodone for pain when her wisdom teeth were removed. She had tried marijuana and cocaine before, but they didn't compare.

When the prescription ran out, Hendricks went from feeling alive to feeling dead.

Her boyfriend told her she was "dope sick" and needed more drugs to feel better. Three weeks later, he introduced Hendricks to the world of heroin. She fell in love with the adrenaline rush.

"In the beginning I liked every minute of it," Hendricks said. "It was the high to get the heroin."

Today, after 10 years of heroin addiction, she's 31 and in jail for violating her probation on a conviction for heroin possession. It's Hendricks' second stay at Ordnance Road.

But for the first time, Hendricks feels motivated to fight her addiction. She's one of 53 inmates enrolled in Road to Recovery, a methadone treatment program run by the Anne Arundel County Health Department.

Anne Arundel is one of just two local governments in Maryland treating opiate addicted inmates with methadone, according to a spokesman for the Maryland Department of Health and Mental Hygiene.

While the program has convinced corrections and public health officials here that methadone works, their counterparts in other counties are reluctant -- some rejecting it as a legal way to get high.

Ordnance Road warden Bill Martin wanted to improve the results he was seeing in his detoxed inmates.

"I think the staff realized that what we were doing in the past really wasn't working," he said.

The goal of Road to Recovery is to prevent opiate addicted inmates from returning to drugs and jail.

In June 2012, the center started a year long trial of the program. Of the 170 inmates who participated, only 27 were sent back to jail. In the past, more than half of all inmates in the jail were rearrested after release.

The results have convinced Martin and the Health Department to continue the program, which costs $325,000 a year. It recently was accredited for another three years by the Commission on Accreditation of Rehabilitation Facilities International.

Bill Rufenacht, county director of behavioral health, said the results have been encouraging.

"People become employed, they are productive, they take care of themselves physically and mentally, they take care of their family," he said. "We think it's the right response for public health to do this."

Heroin abuse

Heroin use in Anne Arundel County remains a growing problem, according to the Health Department. In 2012, there were 17 confirmed heroin overdose deaths -- a 30 percent increase from 2011.

That's slightly higher per capita than statewide, and Maryland has a higher heroin overdose rate than the national level, according to statistics provided by Elin Jones, a Health Department spokeswoman. Heroin use is more common in north county communities.

The first two weeks after a prisoner is released pose the greatest risk of an overdose, the department said. They have a reduced tolerance to opiates after mandatory detox, where addicts stop taking the drug and suffer through the symptoms of withdrawal.

The department, which runs another methadone treatment clinic in Glen Burnie, approached corrections officials about adding treatment to the jail. The Ordnance Road jail is where most people sentenced to jail for less than 18 months serve their sentence.

Martin said he was apprehensive at first because he didn't know much about methadone. But he wanted to improve the results for inmates getting released with just detox. The program is paid for with a grant from the Maryland Alcohol and Drug Abuse Administration.

Suffering from withdrawal, most prisoners search for their next hit as soon as they are back on the streets.

They come out of jail, and they're not going to the treatment centers. So we are starting the process inside," Martin said. "This helps them focus on something, rather than (drugs) pulling at them"

Dr. Lee Gresser, a Health Department physician who supervises the methadone program, said opiate dependency is a chronic disease that needs to be treated with medication.

Methadone stops withdrawal symptoms caused by damage to the brain, which means a recovering addict can focus on getting their life together.

"(Opiates) cause multiple areas of damage to the nerves," he said. "People get symptoms of withdrawal, which include restlessness and anxiety, irritability, depression, runny eyes and nose, sneezing and excess yawning."

Hendricks said the withdrawal symptoms she suffered during the times she tried to quit heroin were agonizing.

"It was like having the flu. I couldn't get off the couch," she said. "Every bone in my body aches. I have thoughts that race through a mile a minute."

Addiction

At the peak of her addiction, Hendricks spent about $2,000 a month on drugs. She started selling it to fund her habit. Hendricks continued to work at the dental practice for a while, but eventually she was fired for having a bad attitude.

The low point came four years ago, when she wrecked her mother's car while high on the tranquilizer Xanax and heroin. Hendricks' mother threw her out, but agreed to look after her 9-month-old son while she moved into a tent with her boyfriend.

"I have stolen from almost every store I've ever been in, every family member who's meant anything to me," Hendricks said. "The people who stood by me, I hurt the most."

During her 10 years of addiction, Hendricks tried to get clean.

Her parents spent $25,000 on a rehab facility in California. Hendricks went through a detox program during her stay, and as soon as she was released she had cravings for heroin.

"As soon as I came back I used," she said. "I didn't have any friends. And I thought the people I was using with were my friends."

In 2010, Hendricks started methadone treatment at a private facility in Laurel. She said she didn't have the motivation to use the treatment properly.

"My whole goal was that I wanted to legally get high," Hendricks said.

She had to stop the treatment after going to jail for trespassing, and lost her health insurance while locked up. Hendricks went through a detox while in jail, and sat lifeless in her dorm all day.

"When I left here, I was suicidal," she said.

Hendricks said she's having a much better experience at the center this time. The treatment program is very strict, and the methadone is helping her stay on track.

Hendricks attends all the meetings offered at the center, and keeps busy by taking trips to the library. She's currently reading the Hunger Games series in her free time.

"(Methadone) stops the cravings, which was a lot of the problem last time," Hendricks said. "Before, my thoughts were, 'Who can I stay with where I can get high?' This time, I'm a totally different person."

The process

Inmates are screened for the program by a nurse and a doctor. They must be dependent on opiates for at least one year to qualify. Qualified inmates are put on a low dose of methadone, which is increased slowly.

Inmates take their dose every morning starting at 5 a.m., administered by a nurse. They also attend group and individual counseling sessions with a therapist.

After an inmate is released, he can continue treatment at a Health Department treatment center for as little as $5 a week.

"They're coming back into our communities, so we want them to be in their best health," said Catherine Robinson, criminal justice program supervisor at the correctional center.

"We don't just drop them off and say, 'See you later.'"

Many county corrections centers in Maryland contract with ConMed, a private firm that provides medical care to inmates in several correctional facilities in Maryland. It uses detoxification to treat heroin addiction, according to corrections officials who use the company.

"It provides them an opportunity to be clean and to purge their body of the substance they're addicted to," said George Kaloroumakis, director of corrections for the Wicomico County Detention Centers.

His agency encourages inmates to seek treatment after release. But those with drug, alcohol and mental health conditions often return to jail. He's interested to learn more about the program in Anne Arundel County.

"If it has long term benefits to individuals, and has benefits economically, it would make sense to give it a consideration," Kalorumakis said.

Detoxed inmates in Somerset County also find their way back in jail after release, Warden Louis Hickman said. However, he said he still isn't interested in adding methadone.

"They need to go cold turkey," Hickman said. "Methadone is a legal way to stay high."

Gresser disagreed, saying opiate addiction needs to be treated the same as any other chronic illness.

"We use (the methadone) appropriately and monitor them," he said. "It's not just the drug helping them function again, it also goes along with close counseling. And that's the case with any disorder."

The future

Hendricks misses her son, now 5. She talks to him on the phone, but doesn't see him. He's still with her mom, and has been told that Hendricks is away at a school for mothers.

"To hear him say, 'Mommy, why can't you come home? Why can't you ask the teacher to send you home?' That just tears me up," she said. "This affects my son to the fullest. My taking drugs would take his path down a different road."

Hendricks said she's getting clean for herself and her son. She would like to go to a halfway house after her release, and continue her methadone treatment with the health department.

Hendricks wants to enroll in the University of Maryland, Baltimore County dental hygienist program and work at a dental practice again. Most importantly, Hendricks wants to strengthen her relationship with her family.

"I want to be a great mom and sister again, be a good daughter, and have my family back," she said.

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