GREENFIELD — An injection to block heroin cravings costs more than $1,300 — money probation officers say uninsured offenders offered the medication can’t afford.
County leaders have set aside some $160,000 to support the latest program aimed at addressing the county’s opioid problem. That money will be refunded by a state program, Recovery Works, that covers two shots per uninsured person.
But the county has to pay the cost for the medication up front — a step probation officials say is necessary to ensure there is no delay providing the medicine to work-release offenders trying to break free from addiction.
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One shot of Vivitrol, which blocks the euphoric effects of opioids, costs $3 to $4 with insurance, officials say. Without insurance, the injection cost leaps to more than $1,300, officials said.
More than 50 percent of the county’s work-release program, which currently oversees 106 offenders, could qualify for the program — meaning they have been convicted of an alcohol or drug-related crime. Others could qualify if they admit they committed a crime to feed their drug habit, though those numbers are harder to track, said community corrections director Pat Powers.
Of the offenders in work-release, an estimated 70 percent lack insurance, community corrections officials said.
Probation officials hope the $160,000 — enough to fund two shots for 60 people who don’t have insurance — fills funding gaps for the next year, said probation department crime-prevention specialist Amy Ikerd.
Ikerd led the charge to bring Vivitrol to Hancock County. She met with a company representative some five years ago, she said. She was intrigued by the concept, but there were few funding options to cover Vivitrol costs for uninsured patients at the time, she said.
Since early April, 38 people sentenced to serve time in a low-security program have been offered three shots of Vivitrol as they transition out of the county jail.
Inmates are screened by the probation department, where officials talk to them about their drug history, and they meet with a jail nurse before receiving their first shot.
That first injection — a free sample from drug manufacturer Alkermes — is given as offenders transition from jail to the county’s low-security community corrections facility, a halfway house or a probation program. While they complete their sentences, they are supervised by an officer who ensures they also attend 12-step meetings or other drug counseling sessions and get their next two monthly shots, probation officials say.
The county council’s $160,800 allocation will be refunded by Recovery Works, an Indiana Department of Mental Health and Addiction program supporting uninsured offenders who have left jail to enter probation programs.
The county will be reimbursed in full for two shots — about $2,600 — per uninsured client, said Marni Lemons, deputy director of communications and media at the family and social services administration.
Recovery Works has the discretion to cover additional shots for an offender, but the county must seek prior approval, Lemons said.
Vivitrol shots stay in a person’s system for 30 days, binding to the opioid receptors in a user’s brain to decrease cravings. If a person uses heroin while Vivitrol is in their system, they’ll immediately experience flu-like withdrawal systems.
Manufacturer Alkermes acknowledges the injection comes with “significant risks,” including accidental overdose if the user takes more drugs to try to overcome the medication, its website states. Other side affects include allergic reactions, nausea, tiredness, headache and dizziness.
Law enforcement officials, who point to addiction as the underlying cause of many local crimes, say the rewards outweigh the risks. Many of the inmates being held in the Hancock County Jail — which housed 204 this week — likely committed crimes to feed a drug habit, officials said.
The effectiveness of the drug — approved by the U.S. Food and Drug Administration in 2010 for treating opioid addiction — has yet to be seen, but early studies show promising results.
In a 2016 study sponsored by the National Institute on Drug Abuse, about 300 offenders who struggled with drug addiction were randomly assigned to receive either Vivitrol coupled with therapy or a referral to a standard addiction counseling program.
After six months, the Vivitrol group had a lower rate of relapse, 43 percent compared with 64 percent. When offenders taking Vivitrol did relapse, the time between drug use was longer — 10.5 weeks compared with five weeks, the study found.
Locally, of the 10 inmates to get the first shots given at the local jail, six tested negative for drug use when they returned for their second shot, officials reported. None of the four who failed the drug test tested positive for heroin, suggesting offenders sought other drugs to get high.
Council member Kent Fisk said local officials need to do more to address the county’s drug problem. Still, he expects there might be pushback from residents or officials who don’t think it’s the county’s responsibility to provide treatment.
“If you don’t believe saving one life out of 10 or 20 is worth it, then you’re not going to enjoy any of these programs; you’re not going to think they’re worth any money.”
Coming clean: The county recently began offering Vivitrol, a medication that reduces cravings, to offenders fighting drug addiction. The medication:
- blocks cravings from opioid-based drugs
- lasts 30 days
- costs more $1,300 before insurance
- cost is covered by the manufacturer for an offender’s first dose
Source: Hancock County Probation Department