Daniel Hanson told his mother and sister he wasn't optimistic that jail would deter his opioid addiction.
Two weeks before he was released from the Hennepin County workhouse, they visited Hanson, 26. He admitted he was an addict. "I'm not planning on using heroin when I get out," they said he told them. "But … I can't make any promises."
Two days after his release in August 2017, Hanson died of an overdose of heroin and methamphetamine in his bedroom in the family's home in Ramsey.
Because of a surge of deaths like Hanson's, Hennepin County officials will soon provide medication to jail and workhouse inmates addicted to opioids after a study revealed that large numbers of them overdose and die shortly after they are released from custody.
Nearly 30 percent of opioid-related deaths in Hennepin County and across Minnesota occurred within one year of an inmate's release, according to a new study the county conducted covering 2015 and 2016. More than half the overdose deaths of Hennepin County residents who were incarcerated took place in the first 90 days after release. Sixteen county residents died of drug overdoses within two weeks of being discharged.
Under the plan expected to launch in April, people entering the Hennepin County jail would be screened for opioid addiction, and if they qualify would be allowed to take alternative medications administered by medical staff. If they're in the jail and already on a medication like methadone, they'd be allowed to continue it — a break from past practice, according to the Sheriff's Office.
At the workhouse — where inmates serve time after their release — residents would be allowed to use the addiction-easing drug methadone, or be put on a different medication. The county would link individuals with opioid addiction with chemical health care programs in the community upon discharge.
"We see a real opportunity for the county to do something different and impactful," said Julie Bauch, opioid coordinator for Hennepin County. "This is really a good example of government doing what it is supposed to do"
People who are on opioids are more likely to commit crimes, often to obtain money to satisfy their cravings, so many of them wind up getting arrested, officials say. "We think the jail or workhouse is the point of intervention where we can do something that has the potential to prevent an opioid-related, death," Bauch said.
When opioid addicts are incarcerated, their drug use is interrupted. Once they're released, they use the drugs at levels they were using before they were locked up. But addiction experts say an addict's body cannot immediately tolerate a return to the same amount of opioids, which leads to overdoses, and sometimes death.
Widespread support
Hanson spent three months in the county workhouse for a probation violation stemming from a three-year-old marijuana arrest. His mother, Robin Hanson of Ramsey, and sister, Cara Craig, recall Daniel as a smart young man who loved to fish, but who became ensnared with drugs.
"Dan wanted to be straight, he wanted to be clean," his sister said. "But the drug wouldn't let him."
Robin Hanson believes the new initiative could have helped her son.
"If he would have had the opportunity to get help while sitting in jail, I think he would still be alive today," she said.
Dr. Gavin Bart, director of addiction medicine at Hennepin Healthcare and one of the advisers on the Hennepin County study, concurs.
"I can't help but think if Mr. Hanson had been on medication when he was incarcerated and at time of release, that his death might have been prevented," Bart said.
Hanson's case is not unique.
Michael Trieschmann, 20, was released from jail on June 8, 2017, and died of a heroin overdose two days later in a Brooklyn Center motel. He was a bright student who graduated from Park Center High School in Brooklyn Park..
"At his funeral, two teachers got up and spoke about how smart and brilliant he was," said his mother, Janine O'Connor. "They were devastated. It touched my heart."
She, too, believes that if her son received help while jailed he might still be alive.
"It might have saved his life and many others," she said.
In its study, Hennepin County examined 775 opioid-related deaths statewide spanning 2015 and 2016. Among the findings, 252 of the deaths occurred in Hennepin County, and more than half died within three months of leaving prison or jail. Blacks and American Indians died in higher percentages than whites after release, according to the study.
Jeremy Zoss, a spokesman for the Hennepin County Sheriff's Office, said that under present policy, if a person comes into jail and they are undergoing a methadone treatment, they are weaned off it within three days, with the exception of pregnant women.
Addicts entering jail are without access to opioids and may experience withdrawal symptoms. Bart said jail nurses currently treat the symptoms, mostly with over-the-counter medications for pain relief, nausea and diarrhea.
Under the new plan, addicts would be able to get medication that treats the addiction such as buprenorphine, often known by its brand name, Suboxone. Bart said the drug not only eases withdrawal, but also alleviates drug craving. On release, inmates would be referred to medical treatment providers who can continue to prescribe the medications.
"They are the only medications shown to reduce the death of overdose by over 50 percent," Bart said.
But officials in some states view methadone as a treatment that replaces one dangerous drug with another. Not all private insurance plans pay for the treatment, and some states have ordered their Medicaid programs not to cover methadone, a powerful opioid which can be addictive.
Dr. Tyler Winkelman, a health policy expert at Hennepin Healthcare and one of the authors of the study, said "the science is clear, that medication for opioid use disorder is the most effective treatment."
Former Hennepin County Sheriff Rich Stanek reported last May that one in five inmates at the jail had used opioids and most of those were still addicted. New Sheriff Dave Hutchinson said Stanek made a good start but he wants to build on it and is supporting the county plan. If it succeeds, he said it should be considered statewide. County Board Chairwoman Marion Greene said she enthusiastically supports the proposal.
Bauch said Hennepin County plans to administer its program with a $500,000 grant it hopes to receive from the state Department of Human Services. Last fall, the state received a federal "opioid response grant" of about $17.7 million over two years. Applications for those funds close Feb. 12.
Catherine Johnson, director of the Hennepin County community corrections program, said she also plans to begin the program in the workhouse by the end of March.
Implementing the plan, she said, will mean "less frequent visits to my facility, the sheriff's jail or the emergency room. It is ultimately less expensive to provide treatment, and besides, it is the right thing to do."
Star Tribune Data Editor MaryJo Webster contributed to this report. Randy Furst • 612-673-4224 Twitter: @randyfurst
