Responding to the opioid crisis, more than 55 law enforcement and criminal justice leaders, including 35 elected sheriffs and prosecutors, have called for harm reduction in prisons.

Harm reduction refers to policies that help, rather than harm, people with substance misuse issues. Law Enforcement Action Partnership (LEAP), a non-profit of law enforcement officials who work to improve the criminal justice system, spearheaded the effort.

The criminal justice leaders signed onto an April 4 letter supporting the use of medication-assisted treatment (MAT) for individuals with opioid use disorder in jails and prisons. MAT provides medications such as suboxone and methadone to help reduce opioid dependency and reduce the likelihood of illegal drug use.

Additionally, the letter seeks expanded access to naloxone and a continuing care plan for when inmates are released from custody – practices proven to reduce the risk of a fatal overdose.

First hand experience cited

“For too long we have tried to punish people into abstaining from drugs rather than expanding access to strategies that work, like medication-assisted treatment,” said Miriam Krinsky, Executive Director of Fair and Just Prosecution, another organizer of the sign-on letter.

“Modern corrections is no longer just detention of accused or sentenced individuals,” said Richard Van Wickler, Superintendent of the Cheshire County Department of Corrections in New Hampshire and speaker for LEAP.

“Society demands that we also serve as a hospital, mental health institution, school, and rehabilitation center. Providing adequate and responsible healthcare to treat addiction through medication-assisted treatment is a requirement, not an option.”

While medical marijuana shows efficacy for reducing opioid dependence, MAT programs are being implemented in more jails and prisons, such as in Boulder, Colorado.

“The Boulder County Jail recognizes the importance of MAT programming in the correctional setting to improve treatment outcomes, reduce recidivism and save lives,” explained Boulder County Sheriff Joe Pelle.

“We continue treatment for inmates who are already in a MAT program upon their arrival, assess their needs and refer them to treatment, educate them and provide naloxone kits for inmates at risk of overdose upon release. We are actively working to implement a comprehensive Medication-Assisted Treatment program as early as summer 2019.”

Science and experience combined

Research establishes the benefits of MAT to both the individual and the community – from increased long-term recovery success rates, to decreased crime and healthcare costs, to decreased likelihood of fatal overdose. Now current and former elected sheriffs, prosecutors and other law enforcement professionals from around the nation signed on to the letter.

Signatories include Sheriffs Karl Leonard (Chesterfield County, Virginia), Ed Gonzalez (Harris County, Texas), and Joe Pelle (Boulder County, Colorado); Police Chief Chris Magnus (Tucson, Arizona); local elected prosecutors John Creuzot (Dallas County, Texas), Michael Dougherty (Boulder, Colorado), Sarah George (Chittenden County, Vermont), Christian Gossett (Winnebago County, Wisconsin), Andrea Harrington (Berkshire County, Massachusetts), Lawrence Krasner (Philadelphia, Pennsylvania) and Beth McCann (Denver, Colorado). Also signing were Rachael Rollins (Suffolk County, Massachusetts), Dan Satterberg (King County, Washington), Carol Siemon (Ingham County, Michigan), David Sullivan (Northwestern District, Massachusetts), Cyrus Vance (New York County, New York), and Andrew Warren (13th Judicial Circuit, Florida); and Attorneys General TJ Donovan (Vermont), Kathleen Jennings (Delaware), Peter Neronha (Rhode Island), and Karl Racine (District of Columbia).

“Cutting people off from medically assisted treatment while in custody flies in the face of proven best practices and increases fatal overdoses when people reenter the community,” noted Krinsky. “It’s time for a different way forward to provide individuals with a healthy recovery plan and keep communities safer and healthier.”

“A prosecutor’s role does not end at the prison door,” added Sarah George, Chittenden County State’s Attorney. “As members of the community tasked with enhancing public safety, we are obligated to use our voices to ensure that, in those instances when people absolutely must be incarcerated, they leave custody in a position to safely reenter their communities.”

The letter comes at an opportune moment as the entire country grapples with increased fatal opioid overdoses and many cities across the country are considering or implementing harm reduction approaches to substance use. One setting where harm reduction strategies, such as MAT, are often lacking, however, is in jails and prisons. Lack of access to MAT persists despite significant evidence demonstrating the consequences of denying adequate medical care to people in correctional institutions, including the health risks of detoxing while in custody and the danger of overdose upon release.

The Centers for Disease Control reports that approximately one in 10 overdose deaths showed evidence of the individual having been released from an institutional setting in the m​​onth preceding their death.

Signatories of the letter cited their role as guardians of public safety as the reason for the joint letter, as well as the need to effectively respond to the opioid crisis that is devastating communities across the country.

Read the full letter with list of signatories by visiting

By Mikayla Hellwich | The Leaf Online