(Refiles to add US Domestic New Service code)
By Laila Kearney
BARNSTABLE, Mass., Sept 3 When William Luz's
father died behind bars last month at 62 of liver failure and
other illnesses tied to a lifetime of illegal drug use, his son,
a former addict himself, could have dulled the pain with heroin.
But Luz, who had been released from jail a few weeks before
his father died, stayed clean. For that, he credits a pioneering
addiction treatment program at the Barnstable County
(Massachusetts) Correctional Facility.
"Honestly, it (the program) saved my life," said Luz, 44, on
a break from his job as a cook at a bustling seafood restaurant
in Sandwich, Massachusetts, not far from where he grew up.
Luz, who served two years for a burglary he committed with
his father, received an injection of the drug naltrexone before
he left Barnstable. The 400-inmate jail offers it to people
addicted to opioids from Vicodin to heroin.
The drug, made by Dublin, Ireland-based Alkermes Plc
and sold under the brand name Vivitrol, blocks
receptors in the brain, reducing cravings and barring users from
getting high for about 25 days at a cost of nearly $1,000 a
Corrections officials and drug addiction specialists say
programs like Barnstable's could help in the fight against
opioid addiction, which has been rising in the United States in
But the programs, which have sprung up in 25 states across
the country, are in early stages and even advocates say more
time is needed to determine the success of naltrexone shots over
the long haul.
Barnstable's program is one of a handful of initiatives in
Massachusetts to take on abuse of heroin and other opioid drugs,
which Governor Deval Patrick has declared a public health
While judges are increasingly sentencing drug-addicted
offenders to naltrexone programs, Barnstable officials say its
"re-entry program" is the first voluntary program in the
country. The program has become the model for similar efforts in
Illinois, Missouri, Maine and elsewhere.
"We've had great success with it thus far," said Barnstable
Sheriff James Cummings.
The jail recently released data showing that out of more
than 100 inmates who have gone through Barnstable's program at
Barnstable, which was launched in April 2012, 21 percent have
That is well below national averages. Nearly 70 percent of
former U.S. inmates are re-arrested within three years, with 57
percent of those arrests taking place within the first year,
according to the U.S. Department of Justice.
See graphic on U.S. prison population by offense: link.reuters.com/ryv72w
Cummings said he decided to try naltrexone as a treatment
for prisoners because it has no euphoric effects, is not
addictive and has no street value, unlike the commonly used
opiate addiction treatment drugs suboxone and methadone, both of
which are composed in part of synthetic opiates that can lead to
The Barnstable program, which also involves ongoing
counseling, housing assistance, job placement and a link to
outpatient care, provides an initial shot of naltrexone about a
week before an inmate is released.
The jail's staff sets up appointments for former inmates to
receive additional shots, which are typically paid for by
Medicaid, in the months following release and tracks their
progress through family contacts and outpatient programs.
Substance abuse specialists are optimistic about naltrexone
but say more time is needed to study its effects, especially in
the case of Vivitrol, which was approved by the U.S. Food and
Drug Administration for opioid treatment in 2010.
"I don't think it's been used enough in clinical practice
yet ... for largely a reason of cost it's not been adopted as a
standard treatment" said Dr. Samuel Ball, chief executive
officer of the National Center on Addiction and Substance Abuse
at Columbia University.
Still, Ball said he is encouraged by naltrexone's effect on
former inmates. "It's one less thing that they need to worry
about, and they've got a lot to worry about," he said.
Raymond Tamasi, who runs the Gosnold on Cape Cod treatment
center, which partners with Barnstable to provide ongoing shots
and counseling to newly freed inmates, agreed that questions
remain about the program's long-term impact on recidivism and
the sobriety of former inmates.
"All of these things need to be looked at, evaluated, but
the concept is very sound," he said.
Vivitrol's maker, Alkermes, is studying the drug's
effectiveness on U.S. prison inmates post-release, but results
are not expected until after April 2015. New York University
also has begun a clinical trial of naltrexone-assisted re-entry
programs, according to the U.S. National Institutes of Health.
Alkermes is the only company offering FDA-approved
naltrexone in an extended-release shot form.
Other corrections officials who have adopted the Barnstable
method are in a wait-and-see phase.
"We are in the beginning stages," said Lisa Wright,
administrator of the Auglaize County, Ohio, jail, which recently
adopted a version of Barnstable's Vivitrol model. "We don't know
what the outcome is."
Cummings said he plans to stick with the program. The cost
of one naltrexone shot, he said, is 45 times less than what it
takes to house an inmate for a year at his jail.
"It's not the magic pill," he said. "It's just another tool,
and as far as we're concerned a very effective tool."
(Editing by Scott Malone and Douglas Royalty)