As state and federal lawmakers weigh measures to combat the nation's opioid addiction epidemic, a pioneering Hennepin County plan is a timely reminder that local government has a role to play and can be a source of pragmatic yet innovative solutions.
The county's new initiative to stem this public health crisis doesn't have an official name, but its aim is to treat with medication a large group of Minnesotans at high risk of addiction to heroin or prescription painkillers — those serving time. This group is also at high risk of dying from their addiction after their release, sometimes swiftly.
In a 2017 survey of 851 inmates at the Hennepin County jail, 20 percent acknowledged using opioid drugs. Most were still hooked on the drugs when they were arrested and a remarkable percentage of them — 64 percent — had previously overdosed.
More recently, another report has shed disturbing light on what happens after inmates are released: Many die swiftly from opioid use complications. "Nearly 30 percent of all opioid deaths in Minnesota (228/775) and in Hennepin County (71/252) occurred within one year of release," according to the analysis commissioned as part of an initiative featured in a Feb. 2 Star Tribune story. "Over half of opioid-related deaths in the year after release occurred in the first 90 days."
Those data-driven findings make clear why the current policy must change. "In Minnesota, treatment for opioid use disorders is rarely available during incarceration or upon release,'' according to the report. This makes no sense. If the battle against opioids is to be won, it must be fought on all fronts.
Viewing jails as a point of intervention is a logical step — one that could save lives and yield other long-term benefits. It could reduce crime in communities by reducing the risk of reoffending to buy drugs. That in turn could ease the strain on the public purse, which foots the bill when someone is locked up. Compassion and the potential for lower crime and cost-savings should be strong selling points to law enforcement not just across the state, but across the nation.
The Hennepin County program's launch is expected this spring, though a small-scale effort has already begun. County officials have applied for a $500,000 state grant to administer it. The dollars would come from the $17.7 million the state received last year as part of the federal fight against opioids. Leveraging the funding to help an at-risk population in the state's most populous county would be appropriate.
The county program's key steps are straightforward: Screen for opioid disorders during intake, provide medications when appropriate to ease withdrawal symptoms, and forge connections for inmates upon release with community treatment professionals. None of these measures seem radical, but for myriad reasons they're generally not standard operating procedure. The cost of providing the medications could be one reason, especially for counties with small populations and tax bases. Lack of nearby treatment options for those newly released is another issue for rural areas.
The Hennepin County plan has understandably caught the eye of law enforcement authorities elsewhere, and there's commendable interest in replicating it. Minnesota Department of Corrections Commissioner Paul Schnell said in a recent interview that Gov. Tim Walz's budget calls for $1.9 million over the next two years to roll out a similar initiative at the state level. This merits bipartisan support at the Capitol.
It is important to note that barriers to opioid addiction treatment exist inside and outside of jail. Regulatory red tape can make it difficult to find a doctor who can prescribe medications to treat addiction. Treatment may also be too costly for those who don't have health insurance or have policies that do not provide robust coverage for chemical dependency.
These challenges require urgent action as well. "Opioid overdoses accounted for more than 42,000 deaths in 2016, more than any previous year on record," according to the U.S. Department of Health and Human Services. All steps must be taken to turn the tide. The Hennepin County program provides one important path forward, and the smart local leadership reflects positively on Minnesota.
