Once you come in here and you have to detox, you're traumatized. You're just constantly shaking because your body's hurting. For the mommies and daddy's out there still running amok, still using time. Some people get a fever, some people are throwing up. But being on some oxen makes it 100 times easier. Jails do sometimes provide some basic care for people in withdrawal, but that can often be gatorated and an ibuprofen. And they're not really fundamentally providing the treatment that somebody with an opioid use disorder needs. In Belingham, Washington, a recent class action lawsuit by the ACLU may impact how inmates across the country are treated for addiction. Wachim County has changed dramatically over the last 15 years. It's still a great community to live in. It's a great community to raise your family. But like the rest of the country, we're experiencing a heroin epidemic that has entrenched itself here in our community and is affecting crime. It's destroying lives and it's destroying families. It's something we're very focused on eradicating here in our community. I've been working for the sheriff's office in the corrections bureau in the jail since 1981, so that's going on 39 years. Approximately 70 to 80 percent of our offender population has some issues with some type of substance. When we're dealing with folks when they're coming into custody, we're almost like a really bad case of the flu or bad case of food poisoning. It's like the flu, but 100 times worse. I've been in addict for 24 years. I was 13 when I first picked up. I've had my issues in the past when I was using and did some stupid things. Other than that, my charges are for driving. I started Suboxone about eight years ago. Suboxone is a form of medication-assisted treatment. It's prescribed by a growing number of physicians to help those suffering from opioid use disorder curb their craving. There had been a couple of times I slipped, I fell off. When I came in last year, I was on Suboxone and they didn't give it to me then, and so I had to detox. And so it set me up for a really hard time not being able to be given my Suboxone in here. When I got out of here, I relapsed. I relapsed for 10 months. I think that if I went back to last year and they gave me Suboxone, I wouldn't be here right now doing 180 days. Our challenge in working with the criminal justice system is the transition from incarceration back out into the community. Charles Watchress runs a medication-assisted treatment program in Wachcom County that often works with inmates in the first few days they're released from jail. When we started our program in 2017 in Wachcom County, we wanted to coordinate and be able to continue delivery of services to our patients. What's your current dose? A 3-8mg tablet. And it's oftentimes not until they get released from jail a week or two later that they said that they were not allowed to continue their medication, went through the horrible withdrawal process, and then were released, and then trying to scramble to get back into treatment. I know Wachcom County has. I've been there so I know exactly that they don't care what you go through in there. When I went in the second and third time for a stupid little things, I actually said I wasn't sick because I know they don't take care of you. They put you on the first floor and they call that sick thing, and they don't check on you. We've always treated withdrawal symptomatically. We can give them pain medication that's normally Tylenol. We'll also use medication that'll help stop diarrhea. We tried to offer Wachcom County jail our support in getting their program off the ground, but it was sort of falling on death of ears. It wasn't until Mark Cook from the ACLU reached out to me and said we're looking at cases where patients are being denied access to medication assisted treatment, and it really started the ball rolling from there. We started looking at this problem of denying people in jails, access to medication probably two or three years ago, and it was in that initial investigation that we started looking at Wachcom County specifically. The County jail had been taking some steps forward. In 2016, Wendy and her medical staff began offering medication assisted treatment to pregnant inmates. If a pregnant woman starts going through withdrawal, she can lose the baby and she may lose her own life. When I first started using heroin, it was 12 years ago. We thought since we could control all other drugs, we could control that one. We ended up being wrong. One time I was actually pregnant with twins and I came in and I lost... I don't know if it was from the jail, but I actually lost the twins, but I did lose them at six months because one heart stopped and then it stopped the other heart. So it was from not taking some locks in those. It's time I'm pregnant too and they've been on it. So like I got in, I told them I was sick, I was on certain medications and I had them within 24 hours, so it's been a lot better. We were working our way towards the medication assisted withdrawal. It's just things are expensive and you've got to plan them in budgets and yet again. At that point, and still I would argue it's not necessarily the community standard within jails. The lawsuit, Court Leaver View, Wachim County was filed in June of 2018. The basic nature of the ADA, the Americans with Disabilities Act, is to sort of prevent people from being discriminated against because of their disability. And having a substance use disorder is akin to having diabetes or heart disease. And what you've seen is that a lot of these facilities don't treat it as the medical issue that it really is. Have you had any overdoses? Oh yeah, I've overdosed twice. Opioid use disorder is probably one of the hardest substance use disorders to treat without medication, but the easiest to treat with medication. Without medication, and this isn't including those incarcerated, there's only about a 10% success rate. I wish I could just stakely and not have to use the box and that makes any sense. But some people can't. One thing I would like, you know, for the judges to understand when people come in and take care of their warrants, and this is why they ran for a couple of years because back in 2018 or 17, they had more force to detox and jail. That's my issue. The basic crux of this case is that people on MAT should be able to stay on that prescription medication too. In April of 2019, Wacom County settled the class action lawsuit with the ACLU and agreed to begin offering medication assisted treatment to inmates suffering from opioid use disorder within 90 days. Money that might have been spent in a lawsuit is now being spent on this program. I think it's a more humane way of dealing with people who have a very, very serious problem. And I'm lucky my sheriff does too. We've agreed to the court retaining jurisdiction of that issue for another year so that we're certain that we're moving forward and fulfilling the commitments that we made, and that's just what we intend to do. I think people have heard about the lawsuit and the results of it and said, well, I guess we better get on the bandwagon. As of July 2019, the ACLU has successfully challenged jails and Massachusetts and Maine to begin their own MAT programs. The states that have incorporated medication assisted treatment into their prison system have had wonderful numbers coming out. They show a significant decrease in recidivism once they're released, significant decrease in mortality once they're released, and a significant increase in treatment engagement once they're released. So there's a lot of evidence that points towards medication assisted treatment. So how about if we just do our chicken? Where would you be without medication assisted treatment? Why have you been able to accomplish? I'd be homeless for sure. I'd probably be dead. What if I'd be able to accomplish? Courage. To be me again. The biggest thing I'd like people to understand is not just our jail, but pretty much all jails aren't just punishment. They are in fact kind of the last social service agency for a community. Got groundy the serenity to accept the things I cannot change, and the courage long to change the things I can.