The first few days after a person trying to get sober is released from jail can be the most challeng...
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The first few days after a person trying to get sober is released from jail can be the most challenging time of their sobriety, especially if they live with opioid use disorder (OUD). For some people with OUD who have been sober in jail, leaving custody can feel like stepping off a cliff without wearing safety equipment. There are a few relapse prevention tools in place.
While inside, a justice-involved person may have been stable on Suboxone (buprenorphine), a life-saving medication that lowers cravings and stops painful withdrawal symptoms. Often, however, the moment the jail doors open, this vital care usually stops abruptly, leaving people without the tools to continue their recovery on the outside. Relapse is common.
California is currently the focal point of a major national effort to address this. By changing how jails, Medicaid, and community hospitals work together, the state is trying to close the re-entry gap and save lives.
To understand why California is changing its system to help people with tools like Suboxone, it helps to look at the numbers.
Nationally, about 63% of people in local jails meet the criteria for having a substance use disorder, and up to 36% of all people with OUD pass through the correctional system every single year, according to recent research from telemedicine treatment providers who worked with rural jails.
About 19% of jailed people report regular use of opioids before their arrest. When they arrive, if they have not already detoxed, they face uncomfortable withdrawals while imprisoned, often coupled with indifferent medical care. Suboxone is an important tool that can’t be abruptly ripped away without consequences.
Getting out of jail after being on medication like suboxone can send a person into withdrawal, and without continued access, they may relapse.
Relapse is a Life-Threatening Risk
When someone with OUD is placed in jail without medication like Suboxone, their body goes through forced withdrawal, and their biological tolerance to opioids plummets. If they return to using drugs after they are released, their body can no longer handle the same doses they took before. They are also at risk of taking contaminated drugs if they’re not aware of the street markets.
Because of this drop in tolerance, research from the CSG Justice Center shows that people released from correctional facilities are 129 times more likely to die from a drug overdose during the first two weeks of freedom compared to the general public.
Providing medications like Suboxone to people in the justice system before and during release cuts their risk of death by 75%.
Currently, not even a quarter of the country provides Medication-Assisted Treatment, but California is bucking that trend completely through several progressive state-wide programs:
Despite these massive efforts, closing the suboxone / MAT gap is not easy. Jails are built for security, not for operating pharmacies or drug treatment programs. Medical teams and correctional staff may clash over the logistics of passing out sublingual (under-the-tongue) Suboxone strips, due to fears that inmates might hide and trade the medication inside the facility.
Even with a perfect relapse prevention plan, real-world factors can completely derail a person’s recovery on day one. Many people literally leave jail without an ID, a phone, money, or a stable place to sleep. If a person is worried about finding shelter or food, keeping a doctor’s appointment for a Suboxone refill becomes incredibly difficult. A plan for sober housing and getting a person on their feet should be in order.
California’s experiment proves that treating addiction as a medical condition rather than a crime works. However, the system will only succeed if the state can successfully hand the baton from the jail cell to the community clinic without letting patients fall through the cracks.
Many people in recovery who leave incarceration behind rely on more than one tool to stay sober. Medication like Suboxone is merely one tool in the box, although it can be vital for people with opioid use disorder. Peer support, especially within the recovery community like Alcoholics Anonymous or Narcotics Anonymous, is vital.
Finally, a safe living space is also essential for people re-entering society. A living space in a sober living home or recovery housing can make a huge difference. Jail programs often have halfway houses, but those are not the same as recovery housing. They will not make sure people get medication like Suboxone. They have rules and drug tests, but they don’t provide an environment where everyone is working toward a new lifestyle. Recovering housing provides a community and a safe space for people to continue on their mission to stay sober and live their best life.
Sobriety is a journey of a day at a time, but a recovery community can help you set your anchor. Many homes in the San Diego area are part of sober communities, with robust 12-step meetings nearby and many alcohol-free activities. Learn more about sober housing options in the area in our directory here.
