When COVID-19 shut down all California prisons for nearly a year, in-class treatment for prisoners with opioid addictions stopped. On Feb. 1, a revamped hobby shop, then a gym, served as spaces for in-class treatments to resume at San Quentin.
The in-class reopening coincided with controversy about prescribing Suboxone to Medication-Assisted Treatment (MAT) participants, as reported by The Sacramento Bee. Suboxone contains the highly addictive opioid buprenorphine, with the overdose-reversal drug naloxone. For this reason, more than a third of California state prison doctors have taken the position that there aren’t enough precautions by prison officials to prevent its abuse.
“I feel like we’re adding to the problem, not taking away from the problem,” said Dr. Steven Sabo in the Bee article.
Sabo works at the California Men’s Colony, a state prison in San Luis Obispo. He spoke on behalf of the physicians’ union policy committee.
The San Francisco Chronicle reported that the 40 overdoses in 2017 were the fourth leading cause of death for California prisoners, higher than infectious diseases, suicide, and homicide. In 2018, the California Department of Corrections and Rehabilitation (CDCR) dealt with nearly 1,000 men and women overdosing from drug or alcohol abuse and in need of medical attention. CDCR data shows 64 California prisoners died of overdoses in 2019.
“We aim to stop a new generation of incarcerated people suffering from addiction and dying from overdoses,” said incarcerated and certified drug counselor Raul Higgins.
Higgins is one of the group of counselors consisting of prison officials, formerly incarcerated and incarcerated persons that offer San Quentin prisoners MAT and Integrated Substance Use Disorder Treatment (ISUDT).
Higgins said, “Today, I am a man driven with vision and purpose. In my nine years of service, helping and encouraging men with addictions is one of the most difficult tasks of all and MAT is very helpful.”
Alex Tata, trained by CDCR on evidence-based curriculum, also teaches ISUDT at San Quentin. She said the classes help participants develop relapse prevention and life skills.
“It’s definitely challenging and it’s humbling,” Tata said. “There are, of course, some who aren’t ready to change and who are resistant, but that is why we are here, to instill hope and motivate them to change their thinking by helping build their confidence and develop their communication and coping skills.”
Tata said that MAT “helps them stay on track and meet the goals that they want. If MAT helps keep them safe, I support that as long as it keeps them from doing risky things.”
She added, “Addiction is a symptom of something greater. Until you fix the root of the problem, the addiction is not going to go away. That’s why I like this work so much, because it gets to the why of the why.”
Kevin Flanagan, 38, incarcerated since 2017, is a MAT/ ISUDT participant. He said that he began using heroin at age 17.
“By the time I was 32, I thought I’d be an addict all my life,” he said, adding that his experience with heroin turned him to criminal activity.
While in prison, Flanagan heard about a program that prescribes Suboxone for people struggling with opioid addictions. He kept going to mental health and medical personnel asking to be put in the MAT program.
Finally, in February 2020, he became a MAT participant and since then he’s had no desire to use drugs.
“That’s with the meds alone,” he said, “but with the classes, it’s really changed my perspective on things.
“What sticks out in the classes is learning how to accept myself and my issues, and objectively take a step back and look at my problems in a way I can deal with them.
‘Sure, there’s people who would abuse it, but more to the point, I can say as many times I’ve been arrested as an adult, 95 percent was because of heroin-related things. Taking away the criminal behavior should be the goal — you can’t punish a disease.”
Cristina Islas-Banthi is the Associate Program Director for the MAT/ISUDT program. She brings 22 years of experience in substance abuse counseling to the program.
Islas-Banthi defines a successful substance abuse program as one that shows there is a willingness from the drug counselors to “be open to learn about what’s needed to help improve lives” and clients ready to “receive guidance and help.”
Shaheeda Yasin, Alcohol and Other Drugs Counselor, is trained by CDCR on an evidence-based curriculum.
“I help them develop strategies to work toward change; the first step is to make the person aware of the problem,” Yasin said. “Then, through interpersonal therapy and a humanistic approach, we work to get the person to see what they want to change in their life. I find that it’s important for me to acknowledge the person’s adverse behavior from their perspective. This opens the door for them to see the problem for themselves.”
Yasin says it’s important to have a good working relationship with incarcerated coworkers.
“For the clients to see that working relationship is motivational to them, so having a mentor who’s incarcerated or formerly incarcerated gives the person struggling confidence that recovery is possible.”
Islas-Banthi added, “I think we have a lot of participants that are interested in doing what we’re doing, being counselors and supporting others. They are willing to be the one to deliver the message to other inmates — success is not about numbers, it’s about what one human being can give to another.”
MAT participant Flanagan finds he is now able to deal with issues more rationally. As an example, he spoke about the suicide of his cousin.
“Just recently, my cousin committed suicide and it was traumatic for me. I talked about it to a friend, but at no point, did I have an inclination to get high. That’s amazing,” Flanagan said. He added, “As to the doctors who don’t like MAT, I’d say it works.”