Webinar Delivers Opioid Screening and Assessment Solutions for Law Enforcement, Justice Practitioners

(Chicago) — More than 1,300 people across the country registered for a July 10 webinar offering solutions for law enforcement and justice system partners on the front lines of responding to the national opioid epidemic.

Moderated by Allison Upton, senior policy analyst at the Council of State Governments (CSG) Justice Center, and hosted by CSG’s National Reentry Resource Center, the webinar, entitled “Opioid Addiction Screening and Assessment for People in the Criminal Justice System,” focuses on best practices for screening and assessing people who have opioid addictions and are in, or at risk of entering, the criminal justice system.

The webinar features a review of available screening instruments and how police and other justice practitioners and first responders can select tools and strategies that work best for their programs and jurisdictions.

Opening remarks were offered by Upton and Andre Bethea, policy advisor for corrections at the U.S. Department of Justice’s Bureau of Justice Assistance, which provided funding support for the webinar. Speakers on screening tools and intervention strategies included Roger Peters, PhD, clinical psychologist and professor in the Department of Mental Health Law and Policy at the University of South Florida, as well as Jac Charlier and Phillip Barbour of the Center for Health and Justice (CHJ) at TASC.

“The tremendous interest in the webinar and these tools speaks to the interest in screening and opioids right now, as law enforcement, justice partners, researchers, behavioral health experts, and community leaders are all coming together to find ways to save lives,” said Charlier, national director for justice initiatives at CHJ. “Screening tools are one of the quickest and easiest ways to identify people who need help right away.”

Peters offered an overview of the need for screening and assessment tools, including the high rates of opioid use disorders and the prevalence of co-occurring mental disorders. In terms of screening, there are a number of specific considerations for opioid addiction, which may include such factors as severity of withdrawal, interactions with alcohol and other drugs, the individual’s overdose history, mental health and medical issues, prior injuries and use of pain medication, risk-taking behavior, criminal justice and/or child welfare system involvement, functional aspects of use, family history, and individual strengths and skills.

Given the urgency of the epidemic and the complexity of issues around opioid addiction, he noted that there are many implications for staff training in signs and symptoms of use as well as withdrawal.

“The good news is we have a wide variety of screening and assessment instruments that are available,” said Peters. “Many of them are free-of-charge, non-proprietary instruments, and these include screens for opioid use withdrawal.”

Barbour, master trainer at CHJ, discussed the development and use of the TCU Drug Screen 5 – Opioid Supplement, co-developed by CHJ with Dr. Kevin Knight and Dr. Patrick Flynn of the TCU Institute of Behavioral Research. The free tool can help determine earlier in the screening and referral process if there is an immediate need for services to address opioid use problems.

“The TCU Drug Screen 5 screens for mild to severe substance use disorders, and is particularly useful when determining placement and level of care in a very quick way,” said Barbour. As a practical resource to help determine who needs immediate access to treatment, “it helps first responders and non-clinical personnel to implement a simpler, faster way to identify people in need of intervention for opioid addiction,” he said.

“There are pathways, or frameworks, that help us understand what this newly emerging field of pre-arrest diversion looks like,” added Charlier. He described five pathways in which first responders, and particularly law enforcement, are connecting to substance use treatment and behavioral health services in communities, such as the Naloxone Plus model, a pre-arrest diversion model that rapidly connects people to treatment after an overdose.

Rather than seeking to replicate a single program model to respond to opioid addiction, Charlier advised, jurisdictions are better served by responding to the problem as well as resources specific to their communities, and seek to “solve that problem by putting the pathways together in the combination that works for your jurisdiction, based on the resources you have, the leadership you have within your police/treatment/community settings, and other factors like your recovery community, time to treatment—all these pathways and frameworks have different combinations, different ‘recipes,’ if you will, that are needed to make them go.”

TASC’s Center for Health and Justice is the national training partner for TCU’s Institute of Behavioral Research, including training on the TCU Drug Screen 5 – Opioid Supplement. For training on the opioid supplement and other TCU resources, or for other resources for law enforcement and justice systems in responding to the opioid epidemic, contact Jac Charlier, national director for justice initiatives at CHJ.

 

 

 

 

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Averting Crisis: Safe Withdrawal in Jail Settings

(Chicago) – Lawsuits and news coverage across the country point to an alarming issue faced by jails: people are going into withdrawal from opioids, alcohol, or other substances while in jail and facing extreme discomfort and sometimes death. From 2010 to 2015, families in at least six states were awarded nearly $11 million in compensation for loved ones who died while being denied routine withdrawal management care in jails.

Jurisdictions can save lives and reduce their possible exposure to costly and time-consuming litigation by creating and enacting policies that ensure adequate care for individuals experiencing withdrawal while in jail. In order to support these efforts, the Center for Health and Justice at TASC has developed a brief for jail administrators, public safety leaders, and county and state policymakers. This brief contains information about safe withdrawal management in jail and resources to aid in developing these procedures.

As the opioid crisis continues, jails across the country are encountering people who are actively using heroin and other opioids and who may go into withdrawal while in jail. Abrupt discontinuation of non-opioid substances, including alcohol and benzodiazepines, can also cause withdrawal.

Jail administrators and personnel play an instrumental role in addressing these issues. They are legally responsible to care for the health and safety of people detained in their facilities and are often involved in identifying and addressing acute and chronic health issues, including substance use disorders. As the opioid crisis endures, jails face a growing need to save lives and reduce their own exposure to litigation risk by ensuring safe withdrawal from illicit opioids and other substances while in jail.

  • A recent national survey found that only 22 percent of individuals serving sentences in jails who met diagnostic criteria for substance abuse or dependence received any type of drug treatment while incarcerated, and only 2 percent of them were provided withdrawal management services.
  • Between 2014 and 2016, at least 20 lawsuits were filed alleging that individuals in jail died from opiate withdrawal complications.
  • Previous court rulings have indicated that failure to provide incarcerated individuals medical treatment for withdrawal symptoms or forcing them to go through withdrawal without proper medical supervision may be a violation of constitutional rights.

“Providing adequate care to people going through withdrawal in jail is a win-win-win—counties reduce their exposure to risk, people going through withdrawal in jail avoid the possibility of an unwarranted death sentence, and their families and friends don’t lose their loved one to a really horrible death,” said Brad Bullock, TASC’s area administrator in southeast Illinois. “From both an ethical and a pragmatic standpoint, enacting these procedures is the right thing to do.”

Several advisory organizations provide guidelines or standards on the provision of care for individuals who are going through withdrawal syndrome while in correctional custody, including the Federal Bureau of Prisons, the World Health Organization, and the National Commission on Correctional Healthcare. These organizations call on jails that do not already have sufficient withdrawal management protocols to develop them, and to hire and train staff to respond to withdrawal and the associated symptoms.

There is consensus that medically supervised withdrawal is ideal whenever possible. Partnerships with local medical providers can help jails safely manage withdrawal syndrome. Additionally, relationships with drug treatment providers can help jails connect people to needed treatment upon release.

The Center for Health and Justice at TASC helps states, counties, and local jurisdictions develop practical, collaborative strategies for improving community health, reducing re-arrest, and saving public dollars.

For more information, please contact Laura Brookes, TASC’s director of policy.

Addiction Policy Forum Announces New Initiatives and Partnerships to Address the Opioid Crisis

(Chicago) — The Addiction Policy Forum, of which TASC is a national partner, has announced several new initiatives to help families in the United States struggling with opioid addiction and other substance use disorders. The programs put in motion key elements of the organization’s multi-year plan announced in October, which offers a comprehensive approach to addressing the growing opioid epidemic.

The Addiction Policy Forum is led by Jessica Hulsey Nickel, who will receive TASC’s 2017 Public Voice Leadership Award at TASC’s annual luncheon in Chicago on December 14.

“The Addiction Policy Forum is making important progress in addressing the disease of addiction,” said TASC President Pam Rodriguez. “A multi-faceted approach is needed for this complex challenge we face as a country. We look forward to working with the Forum on evidence-based programs that aim to improve the criminal justice response to substance use disorders.”

As active partners in the Forum since its inception in 2015, TASC and its Center for Health and Justice offer practical experience and expertise in criminal justice diversion and reentry strategies, while also promoting innovative programs that are making a difference in communities across the country.

“We hear all too often that families and community leaders don’t know where to turn for services that can help loved ones who are in crisis – or prevent the crisis from happening in the first place,” said Nickel, president and chief executive officer of the Addiction Policy Forum. “By working closely to families and experts in the field, we’re creating localized resources and evidence-based tools that will make a real difference in addressing substance use disorders. We are grateful to all of our partner organizations for their ongoing commitment to this important issue.”

The Addiction Policy Forum represents a diverse partnership of organizations, policymakers, and stakeholders committed to working together to elevate awareness around addiction, and to improve programs and policy through a comprehensive response that includes prevention, treatment, recovery, and criminal justice reform.

National Public Health Emergency Declared in Face of Opioid Crisis; TASC and Partners Collaborating to Offer Solutions and Strategies

(Chicago) – Drug overdoses killed more than 64,000 people in the United States in 2016, according to the Centers for Disease Control and Prevention. That’s an average of 175 people per day.

On October 26, President Trump declared the opioid crisis a national public health emergency, “directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis.”

In his announcement, the President indicated that a new policy would overcome the Institutions for Mental Diseases (IMD) exclusion that disallows Medicaid payment for certain services at substance use disorder treatment facilities that have more than 16 beds. He also discussed measures to confront illegal drug trafficking, improve safe prescribing practices, and develop non-addictive painkillers.

No requests for federal funding were attached to the announcement.

“What’s important for people to know is that, with funding, there are solutions that can be brought to bear on this crisis,” said TASC President Pam Rodriguez. “From Chicago to Rockford to the Metro-East region of Illinois, and from Maryland to Ohio, we have been working closely with communities severely affected by this crisis. We are finding and delivering solutions together.”

Nationally, the Addiction Policy Forum, of which TASC is a partner, shares innovative approaches happening in communities across the country, from home-based treatment to family recovery initiatives. Earlier this week, APF shared eight priorities to address addiction in the United States, from helping families in crisis to expanding treatment access to reframing criminal justice.

Collaborative Solutions and Strategies for Justice Systems

Opioid use disorders are highly prevalent among criminal justice populations, according to the National Institute on Drug Abuse. Furthermore, a Washington State study showed that the risk of dying within the first two weeks of release from prison are 12 times higher than for other state residents, with overdose being the leading cause of death.

Working with expert researchers, justice leaders, and practitioners across the country, the Center for Health and Justice at TASC has developed collaborative opioid response strategies and solutions for all points in the justice system, beginning with law enforcement and through to parole.

“As first responders, law enforcement officers often are on the front lines of the epidemic. Not only can they carry naloxone to revive individuals who have overdosed, but can save a lives again by placing people in treatment instead of arresting them,” said Jac Charlier, national director for justice initiatives at the Center for Health and Justice at TASC.

“When police, treatment, and communities work together, there’s an array of public health responses that can happen pre-arrest, before people enter the justice system.”

To this end, TASC is a founding partner in the Policy, Treatment, and Community (PTAC) Collaborative, whose mission is to increase health and public safety by widening community and behavioral health and social service options available through law enforcement diversion. Sharing research and information on robust partnerships to confront the opioid crisis in local jurisdictions, the PTAC Collaborative will hold its inaugural conference on pre-arrest diversion in March 2018.

TASC’s Center for Health and Justice also has worked with partners to develop collaborative responses for jails, courts, and reentry phases of the justice system, as well as tools and strategies that span the continuum, including rapid assessment and treatment capacity expansion.

Additionally, the American Association for the Treatment of Opioid Dependence released a fact sheet earlier this week on the use of medication-assisted treatment for opioid use disorder in the justice system. TASC participated in the expert panel cited in the report.

“Families and communities are hurting,” said Rodriguez. “We’re joining forces with policymakers, justice leaders, and practitioners to help people and communities get the services they need. We need to keep people alive.”

To learn more, visit the Center for Health and Justice (CHJ) at TASC, or contact Jac Charlier, national director for justice initiatives at CHJ.

New Early Identification Opioid Screening Tool Available from Texas Christian University and the Center for Health and Justice at TASC

Quick Screen Helps Provide More Rapid Referral to Treatment

(Chicago) – A new self-report screening tool is available to assist justice and health professionals to quickly gather detailed information about opioid use, allowing for more rapid referral to treatment services when appropriate. It also collects important information about potential risk of opioid drug overdose.

Developed by researchers at the Institute of Behavioral Research (IBR) at Texas Christian University (TCU), along with the Center for Health and Justice at TASC (CHJ), the TCU Drug Screen 5 – Opioid Supplement can help determine earlier in the screening and referral process if there is an immediate need for services to address opioid use problems.

“Dr. Patrick Flynn [IBR Director] and I have worked closely with the Center for Health and Justice at TASC in developing the TCU Drug Screen 5 – Opioid Supplement,” said IBR Deputy Director Dr. Kevin Knight. “We look forward to seeing it used in the field as part of the greater effort to make sure that those in need of services for opioid use problems are identified accurately and linked to the most appropriate level of care.”

The 17-question screen is a freely available resource for addiction and criminal justice professionals , including treatment providers, case managers, pre-arrest diversion and deflection staff, pretrial service providers, probation and parole officers, and jail administrators. By asking questions such as the respondent’s frequency, purpose, and methods of opioid use, the screening tool offers information relevant to immediate need for treatment referral and service delivery.

Given the extent and urgency of the national opioid crisis, responses may help professionals determine earlier in the screening and referral process if individuals should be prioritized for immediate placement into treatment, and also signal if someone may benefit from having access to naloxone (NARCAN®; EVZIO®) in case of overdose.

“With so many professions now on the front lines of fighting the opioid epidemic, people are looking for tools to help them earlier and faster in their decision making,” said Jac Charlier, national director for justice initiatives at the Center for Health and Justice at TASC. “With the new Opioid Supplement, questions specific to opioids now appear in the screening tool, making it easier to identify people earlier who may be at high risk for opioid overdose.”

The tool is a supplement to the TCU Drug Screen 5, which is based on the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The TCU Drug Screen 5 screens for mild to severe substance use disorder, and is particularly useful when determining placement and level of care in treatment.

Questions regarding permission to use the TCU Drug Screen 5 – Opioid Supplement, as well as specific information about the form, should be directed to Dr. Kevin Knight, deputy director of the Institute of Behavioral Research at TCU, at ibr@tcu.edu.

The Center for Health and Justice at TASC (CHJ) is the national training partner for TCU’s Institute of Behavioral Research. For training on the opioid supplement and other TCU resources, contact Jac Charlier, national director for justice initiatives at CHJ.

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The Institute of Behavioral Research (IBR) at TCU is a national research center for evaluating and improving treatment strategies that target reductions in drug abuse, related mental health and social problems, as well as other significant public health risks.

TASC, Inc. (Treatment Alternatives for Safe Communities) provides evidence-based services to reduce rearrest and facilitate recovery for people with substance use and mental health issues. Nationally and internationally, TASC’s Center for Health and Justice offers consultation, training, and public policy solutions that save money, support public safety, and improve community health.