HINCKLEY — When Brock Peters was booked in August 2023 at the Somerset County Jail, he says he “looked like death.”
Brock Peters, 29, who is now living at the Shiller Ranch Recovery Residence in Hinkley, says he is not sure he would still be alive had he not been arrested in August 2023 and given the option of treating his opioid abuse disorder through a new program at the Somerset County Jail in Madison. Rich Abrahamson/Morning Sentinel
“I weighed maybe 130 pounds,” he said. “I was skin and bone. I looked like I was gonna die, and I was.”
Peters, 29, said he is not sure he would still be alive had he not been arrested that day. He was at the height of his opioid addiction, and after being forcefully detoxed and sobering up, he became part of a pilot program at the jail offering a new form of opioid treatment.
That program, he said, is what set him on his path to recovery.
In 2022, the Somerset County Jail at 131 E. Madison Road in Madison began offering inmates the monthly injectable opioid addiction medication Sublocade, while phasing out its use of Suboxone, a daily opioid dependence treatment that has become the standard for treating opioid abuse disorder in jails. It is believed to be the first and only county jail in the country to offer inmates the new treatment.
While the change might sound minor, program founder Alane O’Connor said the program has already been saving lives.
O’Connor has worked in and studied addiction medicine in Maine for more than a decade. She now advises Gov. Janet Mills’ opioid response as the co-chair of the Maine’s Opioid Response Clinical Advisory Committee, and has worked in a variety of programs with MaineGeneral Health, the Maine Medical Association and others throughout the state.
O’Connor helped design and implement the Somerset County Jail’s program, and because the new medication is longer lasting and easier to administer, O’Connor said it is drastically reducing withdrawal symptoms among inmates at the jail.
“For years, there was only one medication that was available,” O’Connor said last week. “We’ve been able to treat four times the number of people that we were able to treat using this medication. The primary difference here is the medication is a once-a-month injectable that doesn’t require the daily trips to the medical facility.”
O’Connor said the program has also been effective at preventing overdoses among the jail’s most vulnerable population: Those recently released from custody.
Many of those arrested on drug charges sober up in jail, effectively resetting their opioid tolerance. Upon their release, however, many inmates return to using the same amount of opiates they were using before their detox, often resulting in overdoses, according to Somerset County Sheriff Dale Lancaster.
“We dry you up and clean you up inside of the jail,” he said. “When they go outside, they try to use the same amount that they got when they left, and it will kill them. It doesn’t take much fentanyl to do it.”
Lancaster, who encouraged and green-lit the program, said he intends for it to be part of a broader push to curb overdoses among those who have been released from jail.
“As long as the (opioid) epidemic is here, we have to provide protection for those people that are leaving incarceration,” Lancaster said. “I believe it’s our responsibility to make sure people are protected when they leave the jail.”
Protecting inmates from overdose after being released from jail has proven difficult for jails administering daily Suboxone because many patients often find themselves without insurance, O’Connor said, or have difficulty finding a doctor willing to prescribe the medication. Because Sublocade remains in a patient’s system for about a month, it provides longer-lasting treatment.
“The risk of overdose deaths (after) release is just off the charts,” she said. “This is a medication that clearly can stabilize people and keep them safe in a very vulnerable period. We have not had a single death in our population of folks that have been released.”
Peters was one of about 70 inmates who joined the program when it began. It started the same way his previous treatment did: With a four-day opioid detox in an isolated wing of the jail. He described the process as “miserable,” but said it was an important first step towards recovery.
“You get put into orange clothes, you get given a blanket, you get some sheets and they ship you off to a pod where you’re essentially in isolation,” Peters said. “I got maybe an hour of sleep a day for a week straight. I mean, you start to go literally crazy. You can’t sleep, you can’t think, you can’t eat. I was lucky to be able to eat two or three saltine crackers a day.
“It’s gonna sound weird, but it’s the biggest blessing that I went through that because I don’t have it in me to do it again, if that makes sense.”
Opioid abuse treatment is a big part of inmate health care. In a presentation on the program that she gave last year, O’Connor said data from 2020 shows that of all admissions to Maine correctional facilities, 75% of men and 86% of women required substance abuse treatment.
Sublocade has been offered to inmates in only a few prisons around the country, O’Connor said, most of which are metropolitan correctional facilities in places like New York and California. That is due largely to the medication’s prohibitively high cost, which O’Connor estimated at about $1,500 a dose.
O’Connor said the Sublocade’s high price tag is “incredibly frustrating,” adding it is available for half the price just 90 miles away from the jail, across the Canadian border.
The cost of Sublocade and Suboxone end up being about the same, however, after factoring in costs associated with administering the medication daily to hundreds of inmates.
“Administering the daily medication, you probably have 10 people in the room,” O’Connor said, “and it would take 15 to 20 minutes to get everything done properly in terms of the medication — mouth checks, taking the medication, drinking water, eating crackers, changing their shirt. This is just a single trip once a month to the medical bay, where patients get the injectable into their abdomen.”
O’Connor has written a scientific study based on the results of the Somerset County Jail’s pilot program, with the aim of showing other rural jails that Sublocade can be a feasible alternative for opioid addiction treatment if they can cover the cost. Her paper is still under review, although she said several jails across the state have reached out about implementing similar programs.
The Somerset County Jail was able to afford the project through a grant from Maine’s Office of Behavioral Health and Gordon Smith, the state’s opioid response director. O’Connor said she seeks to expand the program by building similar partnerships between the state and other rural jails.
“To be honest, the only barrier is cost,” she said. “We really need the state’s support for that piece of it.”
Peters, who said he would not have entered recovery were it not for Sublocade, has joined O’Connor in advocating for the program’s expansion. To him, every life is worth saving, no matter the cost.
“When you see somebody get clean, you you really see the life come back into their soul,” he said. “Everyone’s worth saving. Everyone. That’s the biggest takeaway.”
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