OP-ED: In Heroin Fight, Public Health Strategy, Vivitrol Are Key Weapons

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Vivitrol reduces opioid cravings and prevents relapse by blocking the opioid receptors.

OP-ED: First and foremost, Illinois public officials – legislators and the governor alike – must recognize that the Illinois heroin crisis is a public health crisis.

For that reason, we applaud lawmakers of the Illinois House Heroin Crisis Task Force for approaching and taking testimony from Winnebago County public health stakeholders at its public hearing held in Rockford on July 7.

Treatment Alternatives for Safe Communities, which has served northern Illinois since 1981 by designing and administering programs that connect individuals involved in the criminal justice system with supervised, community-based drug treatment and recovery support, knows from our decades of reaching tens of thousands of individuals across Illinois that drug addiction requires treatment and recovery management. The most effective treatments will vary depending on the type of drug and the characteristics of the individual. Treatment can encompass a combination of behavior therapies, counseling, ancillary services, and medication assistance.

Individuals highly susceptible to overdose include those who have been released from jail, prison, inpatient treatment, or hospitalization. Periods of abstinence lower the body’s tolerance for the drug and greatly elevate the risk of overdose and death. We know, for example, that client education, communication among systems, and intensive case management can literally be life-saving when a person with opiate addiction is released. We can—and have—prevented tragedies by implementing communication alerts, intervention processes, and vigilant case management at these critical junctures of risk.

In addition to such interventions, other advances include the use of FDA-approved medications, provided in conjunction with clinical therapy in order to prevent overdose and boost recovery.

Approved medications include methadone, buprenorphine, and naltrexone. There are various brand names for these medications and combinations of them, including but not limited to Suboxone, which is a combination of buprenorphine and naloxone; and Vivitrol, Revia, and Depade, which are different forms of naltrexone.

In the Winnebago County Drug Court, for example, TASC and our partners have witnessed the effectiveness of Vivitrol, which reduces opioid cravings and prevents relapse by blocking the opioid receptors. In this particular program, clients receive Vivitrol along with treatment and TASC case management. Since this program was initiated – specifically for drug court clients with opiate addictions – client overdoses or hospitalizations have dropped to zero.

Despite TASC’s own success with Vivitrol, the broader heroin risk remains ever present in Winnebago County.

Several weeks ago, the Winnebago County Coroner reported that 18 of the 42 overdose deaths in Winnebago County so far this year were heroin-related.

By adopting a public health-centered strategy that includes FDA-approved medications, such as Vivitrol, the State of Illinois can begin to turn the tide in the heroin epidemic tragedy. But if the public health approach is ignored by lawmakers and the governor, the heroin scourge will continue to swamp communities.

Bridget Kiely, BA, CADC, CCJAP

Board Registered Interventionist

Treatment Alternatives for Safe Communities Administrator

Rockford, Illinois

TASC Leaders Featured in 2014 National Drug Control Strategy and White House Video

(Chicago) –  TASC President Pamela F. Rodriguez and President Emeritus Melody M. Heaps are featured in the 2014 National Drug Control Strategy, released July 9 by the White House Office of National Drug Control Policy (ONDCP).

Rodriguez, TASC’s president and CEO since 2009, and Heaps, who founded the agency and led it for 33 years, were honored at the White House in March as Advocates for Action for their national leadership in advancing system-wide justice interventions for people with substance use disorders. Advocates for Action is an initiative by ONCDP to recognize individuals’ achievements in improving the health and safety of their communities by combating the cycle of drug use and crime.

“Pamela Rodriguez and Melody Heaps are re-designing the criminal justice system to break the cycle of addiction, arrest, and incarceration,” says the introduction to a new video on the White House website.

As witnesses to the societal impact of illicit drugs and criminal justice responses over the past 40 years, Rodriguez and Heaps provide a concise history of these issues in the 11-minute video. They discuss the origins of TASC, the generational influences of drugs and crime in communities, the importance of appropriately diverting people with substance use and mental health problems from the justice system into health services in the community, and the significant opportunities that the Affordable Care Act presents in reducing rates of mass incarceration and recidivism by increasing access to behavioral health treatment.

In addition, TASC’s work in supporting systemic change via evidence-based sentencing is profiled in the national strategy’s fourth chapter: Break the Cycle of Drug Use, Crime, Delinquency, and Incarceration. With funding from ONDCP, and along with a team of national partners, TASC and its Center for Health and Justice are working with national law enforcement leaders to provide training on the science of addiction and how this understanding can inform police practices and policies.

The National Drug Control Strategy is published annually and provides key strategies and successful models for reducing illicit drug use and its consequences.

Researchers to Study Impact of Affordable Care Act on Public Safety; Cook County Key Research Site

(New York)Laura and John Arnold Foundation (LAJF) has announced a grant to a team of researchers at Johns Hopkins Bloomberg School of Public Health and Harvard Medical School to study the Affordable Care Act’s (ACA) impact on public safety.

The project will examine innovative programs focused on providing formerly incarcerated individuals with access to medical, behavioral health, and social services under the Affordable Care Act (ACA).

“Our aim is to identify possible links that may help to explain whether improved access to health care can contribute to a reduction in crime,” said Haiden Huskamp, a professor in the Department of Health Care Policy at Harvard Medical School. Dr. Huskamp is leading the study along with Colleen Barry, an associate professor and associate chair for Research and Practice at Johns Hopkins Bloomberg School of Public Health.

An inventory will be produced as part of the overall Hopkins/Harvard study and will be available at the end of the calendar year. The research will include an in-depth study of a unique partnership in Illinois between the Cook County Health and Hospitals System, the Cook County Sheriff’s Office, and TASC (Treatment Alternatives for Safe Communities), with the location being inside the Cook County Jail where thousands of individuals who are exiting the jail have been signed up for Medicaid coverage.

People involved in the criminal justice system often have extensive health care needs. More than two thirds of jail detainees meet clinical criteria for substance dependence or abuse, and 14.5 percent of men and 31 percent of women entering jail have a serious mental illness. Yet, studies find that the overwhelming majority of people leaving jail – 80-90 percent – do not have health insurance. New health care options under the ACA will allow many of these individuals to receive coverage.

“The goal of this project is to learn everything we can about how the ACA is being used nationally to make our communities safer and to improve public health,” said LJAF Vice President of Criminal Justice Anne Milgram.

Dr. Barry emphasized the importance of conducting in-depth studies of earlier innovator programs that are currently enrolling individuals exiting jails and prisons in Medicaid under the ACA, and developing ways to connect them to mental health, addiction, and other medical and social services in their communities.

“Early programs like the Cook County partnership have the potential to improve population health and may lower crime, so it is essential to learn lessons from their experiences and to share insights with jurisdictions in other areas of the country considering initiating similar efforts,” said Dr. Barry.

Research findings will be published in a peer-reviewed journal within the next year.

Mental Health Court Celebrates 10 Years

(Chicago) — The Cook County Mental Health Court celebrated its 10-year anniversary on May 20, graduating three recent participants and lauding the successes of numerous past graduates.

Since its inception in 2004, the specialty court has served 663 people. It is unique in that it is specifically designed to serve felony probationers who have chronic mental health conditions, most of whom also have co-occurring substance dependencies.

The goal of the mental health court is to reduce repeated histories of arrest and incarceration among participants by providing comprehensive clinical services delivered by a coordinated team of partners.

“We’re here for a reason, and it’s not to lock everybody up,” said Judge Paul P. Biebel, Jr., presiding judge of the Criminal Division of the Circuit Court of Cook County. “This is important work, and it touches our souls watching people come back from challenging situations, beating drugs and mental illness. We’re very proud of them, and we congratulate today’s graduates.”

An estimated 20 percent of people entering the Cook County Jail suffer from serious mental illness, often with co-occurring substance use disorders and medical conditions.

Compared to the year before program involvement, the average number of arrests among participants during the first year of the program decreased by 80 percent, according to the Cook County State’s Attorney’s office. Additionally, the average number of days spent in jail dropped by 76 percent, resulting in estimated yearly savings to the county of almost $8 million.

Director of Specialty Courts and retired judge Lawrence Fox, along with Judge Biebel and TASC President Pamela Rodriguez, was instrumental in establishing the Cook County Mental Health Court, now operating in seven courtrooms across the county. Judge Fox commended the program for effectively diverting people from jail and saving lives and families.

“I’m the luckiest guy in the room — able to retire as a judge to work on these programs, instead of having to do the difficult work of putting people in prison,” said Judge Fox. “These courts are far and away the model courts for the country. The court system cares about these participants, and there’s no better work you can do than be part of helping people make changes in their lives.”

TASC Vice President of Operations Janelle Prueter spoke on behalf of TASC about how the program has helped hundreds of people involved in the criminal justice system to receive medical treatment and counseling instead of jail.

“Thanks to the judges for their vision and commitment to this work, and for ensuring that people with mental illness can be diverted from the system and get the help they need,” said Prueter. “Thanks to the clients, for the privilege of getting to do work and be of service to them. We honor the transformation they’ve achieved in their lives.”

Kimberly, who graduated from the program in 2009, was among several former clients who gave words of encouragement to the new graduates. With a former graduate and close friend standing at her side, she explained how the judge and TASC never gave up on her even when she seemed to lose all strength.

“I did TASC and was sober for six years,” said Kimberly. “But I didn’t want to face my other problems. I kept remembering TASC, and I called Pam (Ewing, TASC caseworker), and I got into Mental Health Court. And I realized they love me more than I love me. My advice to today’s graduates — when you fall down, never stay stuck.”

The mental health court was created in Cook County in 2004 as a plan for more effective and coordinated programs and services for people with mental illnesses. It focuses on facilitating communications and linking services across criminal justice, mental health and addiction treatment, and community services. Cook County’s program is distinctive because of its emphasis on systemic change, its selection of felony probationers with non-violent offenses as the target population, and its focus on post-adjudication services. It is funded by federal, state, and court grants.

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Members of the Cook County Mental Health Court team (left to right): Director of Specialty Courts Judge Lawrence Fox; Assistant State’s Attorney Emily Cole; TASC Clinical Case Manager Rachel Wendt; Judge Thomas Gainer; Mental Health Probation Officer Michelle Hargon; TASC Clinical Supervisor Pam Ewing; and Judge Clayton Crane. (Photo: TASC)

Members of the Cook County Mental Health Court team (left to right): Director of Specialty Courts Judge Lawrence Fox; Assistant State’s Attorney Emily Cole; TASC Clinical Case Manager Rachel Wendt; Judge Thomas Gainer; Mental Health Probation Officer Michelle Hargon; TASC Clinical Supervisor Pam Ewing; and Judge Clayton Crane.
(Photo: TASC)

 

 

 

 

Sam’s Club Donation Helps TASC Serve Parents & Babies

sc logo(Chicago) – Two TASC programs that serve children and families in Chicago and Peoria have received generous donations from Bentonville, Arkansas-based Sam’s Club. The donations include nearly 800 containers of baby formula as well as 1,100 diapers and nearly 8,000 wipes.

The gift was facilitated by Ivie & Associates and Diamond Marketing Solutions, an Illinois-based company.

For the more than 2,600 families TASC supports through these programs, the items provide critical relief for household budgets that are severely strained. A 2013 report published in the journal Pediatrics found that 30 percent of mothers in poverty report that an adequate supply of diapers is unaffordable to them, correlating to significantly increased maternal depression and anxiety, which also creates greater social, emotional, and behavioral risks for children.

A sufficient supply of diapers costs an average of $18 per week per child, the study reported. Almost 8 percent of women reported changing diapers less frequently when their supply is running short, creating significant risks for baby diaper rash and urinary tract infections.

The federal SNAP (food stamp) program does not allow for the purchase of diapers, and families in poverty often lack washing machines to clean cloth diapers. In Illinois, State Senator Michael Frerichs (D-Champaign) proposed legislation earlier this year (SB2672) to exempt diapers from sales tax.

The diapers and other donations to TASC from Sam’s Club directly support families in Illinois who struggle with these basic necessities.

TASC Executive Vice President Peter Palanca (left) and Philanthropy Director Ben Underwood (right) with donated formula ready to deliver to families.

TASC Executive Vice President Peter Palanca (left) and Philanthropy Director Ben Underwood (right) with donated formula ready to deliver to families.

In Chicago, the Recovery Coach Program helps parents with alcohol or other drug problems achieve the sobriety and wellness they need to be the parents their children deserve. TASC works with each client individually, developing a recovery plan and ensuring that parents have access to the community-based support services they need to provide a healthy and stable home.

DSCF6460In Peoria, TASC’s Smart Start  program serves low-income, high-risk women and girls who are pregnant or who have children under age five. Smart Start was created as a response to an infant mortality crisis in Peoria County, where in recent years the local infant mortality rate has been alarmingly higher than the national average. TASC’s intensive one-on-one work with at-risk mothers ensures that they receive proper prenatal care and education, and helps women build and maintain healthy lives for themselves and

“TASC is deeply grateful to have Sam’s Club, Ivie & Associates, and Diamond Marketing Solutions as partners in our work,” said TASC Executive Vice President Peter Palanca. “Without basic necessities like diapers, parents struggle and children suffer. It truly takes all of us working together to help children grow up in healthy families.”

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Report: Racial Imbalances, Lesser Offenses Highlight Illinois Juvenile Transfers to Adult Court

(Chicago) –There was only one white boy among 257 children automatically transferred to adult court in Cook County from 2010 through 2012, says a new report by the Illinois-based Juvenile Justice Initiative.

Furthermore, only 13 percent of Illinois children charged with crimes between 2010-2012 requiring an automatic transfer to adult court were charged with first-degree murder.

“Contrary to popular belief that ‘automatic’ transfer is used only on the most serious cases, only 13 percent of automatic transfers had charges of first-degree murder during a recent three-year review,” according to the Commission’s study of juvenile detention in Cook County.

The report, Automatic Adult Prosecution of Children in Cook County, Illinois 2010-2012, found that the 54 percent of juveniles under 17 who automatically were transferred to adult court ended up being convicted for lesser offenses—charges that would not have originally triggered a transfer. Another 4 percent were found not guilty or the cases thrown out.

By contrast, when juvenile court judges made the transfer decision in a court hearing, almost half of cases (48 percent) involved first-degree murder, the report states.

“Illinois is one of only 14 states to give this kind of extreme power to prosecutors, and we found the Cook County state’s attorney employed it almost exclusively in cases involving minority defendants,” said Elizabeth Clarke, president of the Juvenile Justice Initiative (JJI).  “With the stroke of a pen, prosecutors can transform a child into an adult. Time and time again it happens to children of color in Chicago.”

Under Illinois’ automatic transfer law, which was in effect during the study of 2010 through 2012, anyone age 15 or 16 charged with certain felonies automatically bypasses the more rehabilitation-focused juvenile court, and there is no judicial review or appeal of a prosecutor’s decision to try a child in adult court.

Since the time of the study, the age of juvenile court jurisdiction in Illinois was raised to 17, and now 15-, 16-, and 17-year-olds can face automatic transfer to adult court when charged with murder, aggravated criminal sexual assault, and several other felony charges.

In 1982, the Illinois General Assembly removed juvenile court approval of the decision to try a child under age 17 as an adult.

Under the “automatic transfer” law, children age 15 or 16 charged with certain felony offenses are “automatically” tried and sentenced in adult court. The legislature removed the ability of a juvenile court judge to consider each case individually, and eliminated any consideration of factors including background, degree of participation in the offense, mental and physical health, educational issues, and availability of resources unique to juvenile court for rehabilitation.

The average time for a child awaiting trial as an adult ranged from 377 days up to 572 days. By contrast, half of the children charged in juvenile court spend a month or less in detention, the reported noted.

“Trial in adult court fails to protect public safety—children tried as adults typically spend more time waiting for trial, more time in prison, and are less likely to receive rehabilitative services,” said co-author David Reed.

Clarke also said that nearly nine out of 10 youth sent to adult court entered guilty pleas.

“These children are questioned by police without an attorney to represent them, then charged in adult court on the basis of their statements,” said Clarke. “Ninety percent end up entering guilty pleas, nearly half to lesser offenses.  With a guilty plea, there is no trial, no meaningful sentencing hearing, and no opportunity for appellate review.”

Legislation, House Bill 4538, which would restore judicial decision-making authority to determine whether a youth is tried in juvenile or adult court, is under consideration in Springfield.

“It is time to restore individualized decision making on the critical issue of whether to try a child in adult court,” said State Rep. Elaine Nekritz (D-Northbrook), the bill’s chief sponsor, who has introduced the plan to eliminate automatic transfers to adult criminal prosecution.

Nekritz’s measure has drawn support from a top criminal justice reform advocate.

“Justice is being denied to Illinois children who are automatically transferred to adult court, and there is a vastly disproportionate impact on minority youth,” said TASC President Pamela Rodriguez. “The legislature should support Rep. Nekritz’s bill to return judicial discretion to judges, enabling them to take into account the child’s age and individual circumstances when deciding the appropriate court venue.”

TASC VP, Experts Spotlight Prevention, Treatment Funding at Illinois House Heroin Hearing

TASC Executive Vice President Peter Palanca testifies before House Task Force on Heroin Crisis (photo: David Ormsby)

TASC Executive Vice President Peter Palanca testifies before the Illinois House Task Force on Heroin Crisis (photo: David Ormsby)

(Chicago) – A top TASC official, a local prosecutor, and health experts sent a clear message to lawmakers at an Illinois House heroin hearing this week: prevention and treatment funding are a priority.

The new House Task Force on Heroin Crisis held its first hearing in Chicago on Tuesday and took testimony from health and criminal justice experts, including TASC Executive Vice President Peter Palanca.

House task force members present at the hearing – State Reps. Lou Lang (D-Skokie), who chairs the panel, Patricia Bellock (R-Hinsdale), Dan Brady (R-Bloomington), Mary Flowers (D-Chicago), Esther Golar (D-Chicago), and Chris Welch (D-Hillside) – heard witnesses testify on multiple dimensions of Illinois’ heroin crisis. In addition to treatment and prevention funding, testifiers highlighted the science of addiction, describing it as a “medical disease,” and cited the law enforcement challenge of stopping illegal drug sales happening by way of pre-paid mobile phones that lack owner identification.

DuPage County Coroner Dr. Richard Jorgensen, a former emergency room surgeon, explained to legislators the medical impact of heroin on the brain and stressed how the drug’s purity has intensified. He also issued an alarm about the over-prescription of opiate painkillers.

Of those who become addicted to heroin, he said, “Most people become addicted through prescription drugs, and then turn to heroin because it’s cheaper.”

Additionally, Jorgensen emphasized that heroin use is a medical issue, not a criminal justice issue.

“You can’t criminalize your way out of this epidemic,” said Jorgensen. “I really believe that all the prevention dollars that you put in come back many times over.”

TASC’s Palanca bluntly told the committee that solutions are well known and need to be implemented. “The solutions aren’t rocket science and they need to be brought to scale,” said Palanca. “Those solutions include use of proven medications, evidence-based treatment, and prevention.”

Lang told Palanca that the task force plans on leaning on his organization’s expertise.

“We know because of the history of your fine organization that you have a lot to offer us,” said Lang.

Dr. Joseph Troiani, director of Behavioral Health Programs for the Will County Health Department, pointed to the heavy budget cuts inflicted on Illinois’ drug prevention and treatment programs, noting that prevention funding has been cut 88% and drug treatment more than 40% since 2009.

Troiani also stressed that Medicaid expansion under the Affordable Care Act provides an opportunity to expand treatment services, but warned that the issue of capacity – building facilities – needs to be addressed, saying that capital funding for bricks and mortar is critical.

Following testimony by Dr. Seth Eisenberg, medical director for the Illinois Department of Human Services’ Division of Alcoholism and Substance Abuse, Lang asked Eisenberg to “provide to this committee your ideal budget. We know there’s been a cut. What would it take?”

Also testifying at the hearing were Will County State’s Attorney James Glasgow, Cook County State’s Attorney’s Narcotics Prosecution Bureau Chief Brian Sexton, and April Marin and Cassandra Wingert, family members of heroin overdose victims.

Marin testified that her 20-year-old son, whom she suspects was trying heroin for the first time, had typed into Google just days before he died from an overdose, “How much heroin can you safely snort?”

Marin has made it her mission to promote intervention, education, and prevention, entreating legislators for their support.