Here & Now

State Corrections Secretary Discusses New Opioid Program

FREDERICA FREYBERG:

THE USE OF HEROIN IN WISCONSIN IS FOUR TIMES THE NATIONAL AVERAGE AND IN ONE PART OF THE STATE ITS USE GREW BY TRIPLE DIGITS IN JUST TWO YEARS. AS PART OF A STATE EFFORT TO STEM HEROIN USE, ABUSE AND ADDICTION THE STATE DEPARTMENT OF CORRECTIONS THIS SPRING EMBARKED ON A PILOT PROGRAM IN COUNTIES AROUND GREEN BAY WHERE THE AGENCY RUNS FIVE INSTITUTIONS. THE PILOT INCLUDES GIVING A DRUG THAT BLOCKS THE HIGH OF HEROIN TO SOON-TO-BE RELEASED INMATES AND OFFENDERS ON COMMUNITY SUPERVISION. THE DRUG IS CALLED VIVITROL. AND STUDIES HAVE SHOWN 25% OF PEOPLE WHO GET THE MONTHLY INJECTIONS RELAPSE WITHIN A YEAR COMPARED TO 59% WHO AREN’T GIVEN THE DRUG. HOW IS THE $1.7 MILLION TWO YEAR PILOT PROGRESSING IN WISCONSIN AND WILL THE WISCONSIN DEPARTMENT OF CORRECTIONS SEEK TO CONTINUE AND EXPAND IT? WE TURN TO CORRECTIONS SECRETARY JON LITSCHER. THANK YOU FOR BEING HERE.

JON LITSCHER:

NICE TO BE HERE.

FREDERICA FREYBERG:

ON THIS DRUG CALLED VIVITROL HOW DOES USING IT DIFFER FROM, SAY, TREATMENT WITH METHADONE?

JON LITSCHER:

THE BASIC TREATMENT OF VIVITROL IS AN INJECTION AND THE INJECTION GOES INTO EFFECT IMMEDIATELY AND IT LASTS WITH A PERSON THAT HAS BEEN INJECTED, AN OFFENDER IN THIS CASE, FOR AN ENTIRE MONTH. WHERE THE OTHER METHADONE BASICALLY IS A PILL AND IT IS A DAILY ACTIVITY, AND IT HAS TO BE ADMINISTERED. METHADONE HAS TO BE ADMINISTERED AT A CERTIFIED SITE. AS A RESULT, THE ASPECT FOR OUR POPULATION THAT IS PARTICIPATING IN THE PILOT, THE VIVITROL PLUS THE WRAPAROUND SERVICES WE FEEL IS MUCH MORE EFFECTIVE AND IT’S LESS INTRUSIVE IN AN OFFENDER’S LIFE WHEN HE WANTS TO GO TO WORK OR SHE WANTS TO GO TO WORK OR WHATEVER THE CASE MAY BE WITH THEIR DAILY LIVES. THIS METHODOLOGY, THIS MEDICATION-ASSISTED TREATMENT, VIVITROL, MEETS OUR OFFENDERS’ NEEDS BETTER AND WE THINK IS A MORE EFFECTIVE LONG-TERM SOLUTION TO THE CRAVINGS THAT OPIOID-INJECTED — OR OPIOID REPLACEMENT. ANY TYPE OF AN OPIATE ADDICTION MAY CAUSE. ALSO WITH METHADONE, THAT IS AN OPIOID-BASED MEDICATION AND AS A RESULT THAT CAN STABILIZE AN OFFENDER IF THEY’RE ON A DAILY TREATMENT BUT IT IS STILL OPIATE BASED IN THEIR SYSTEM. WE HAVE PREFERRED TO GO TO A NON-OPIATE BASED INJECTION OF VIVITROL AND THEN WITH THE WRAPAROUND SERVICES. I CAN’T INTERJECT ENOUGH THAT CRITICAL IS THE SUPPORT SERVICES WITH THE INJECTION, NOT JUST THE INJECTION ITSELF.

FREDERICA FREYBERG:

SO ARE YOU SEEING SUCCESS WITH THIS PILOT, WITH THE PEOPLE USING THIS DRUG?

JON LITSCHER:

WE BELIEVE SO. I THINK WE HAVE ONLY BEEN — WE BEGAN THIS IN APRIL OF 2016. WE DON’T HAVE ANY WHAT I CALL LONGITUDINAL STUDIES BUT ANECDOTALLY, YES, WE DO SEE SUCCESS WITH THOSE INDIVIDUALS CURRENTLY STAYING WITH THE PROGRAM. WE CURRENLTY HAVE 49 INDIVIDUALS THAT ARE INVOLVED WITH THE INJECTION ON A MONTHLY BASIS, PLUS THE SUPPORT SERVICES. AND THEY ARE MAINTAINING THEIR LIVES, CRIME-FREE AND THEY ARE MAINTAINING THEIR LIVES AS A PRODUCTIVE CITIZEN.

FREDERICA FREYBERG:

WHAT HAS BEEN THE EXPERIENCE IN OTHER STATES THAT HAVE ALSO TRIED THIS?

JON LITSCHER:

AGAIN, THERE JUST HASN’T BEEN THE STUDIES THAT HAVE — CAN IDENTIFY SUCCESS. I THINK YOU MENTIONED THE ONE EARLIER THAT IT SHOWS THAT THOSE INDIVIDUALS THAT HAVE VIVITROL USE THAT, THEIR RECIDIVISM REPEAT RATE HAS BEEN BASICALLY CUT IN HALF. AND IF THAT STUDY HOLDS UP, THEN IT ABSOLUTELY IS WORTH NOT ONLY THE MONEY THAT IS SPENT BUT THE EFFORT THAT IS SPENT TO WORK ON A TOTAL PROGRAM FOR SERVICES FOR THESE OFFENDERS.

FREDERICA FREYBERG:

HOW BIG IS THE OPIOID PROBLEM AMONG INMATES IN WISCONSIN PRISONS?

JON LITSCHER:

WE CURRENTLY HAVE IDENTIFIED JUST A LITTLE OVER 7% OF OUR POPULATION THAT HAS SOME FORM OF OPIATE ADDICTION ISSUE, WHICH AMOUNTS TO APPROXIMATELY 1600 OFFENDERS. SO THE BASE THAT IS THERE TO DRAW FROM IS LARGE. ALTHOUGH WE DO USE IT IN CONJUNCTION WITH WHAT WE CALL THE EARNED RELEASE PROGRAM WHERE A JUDGE FOR ALCOHOL OR DRUG DEPENDENCY CAN GIVE AN EARNED RELEASE DATE WHICH WOULD BE LESS THAN HIS OR HER RELEASE DATE PROVIDING THEY DO THE TREATMENT INSIDE AND CONTINUE WITH THE SUPPORT SERVICES ONCE THEY ARE ON THE STREET.

FREDERICA FREYBERG:

BECAUSE THIS IS A VOLUNTARY PROGRAM. THESE PEOPLE WHO ARE IN IT HAVE TO SAY YES, I WANT TO DO THAT. WHAT ARE THE KNOWN RISKS OF THIS DRUG, THOUGH?

JON LITSCHER:

I’M NOT A MEDICAL DOCTOR SO WHAT I’M TELLING YOU IS BASICALLY WHAT I HAVE READ AND WHAT I HAVE HEARD. SO I MUST SAY THAT AS A CAVEAT. THE BASIC ISSUE OF REAL CAUSE AND CONCERN IS BECAUSE THIS BLOCKS THE ADDICTION HIGH THAT COMES FROM USING AN OPIATE, A PERSON TO GET — WILL NOT FEEL THE EFFECTS OF AN OPIATE-INGESTED PILL OR HEROIN SHOT ITSELF AND AS A RESULT, THEY CAN OVERDOSE SIMPLY BECAUSE THEY ARE TAKING MORE AND MORE AND MORE AND THEN IT BECOMES A PULMONARY CAUSE AND AS A RESULT COULD OVERDOSE WITHOUT EVEN KNOWING IT. YESTERDAY I SPENT THE ENTIRE DAY — I’M ON THE OPIATE HEROIN TASK FORCE THAT WAS ESTABLISHED BY THE GOVERNOR HERE JUST RECENTLY CHAIRED BY LIEUTENANT GOVERNOR AND REPRESENTATIVE NYGREN. THAT CAME OUT VERY LOUD AND CLEAR BY THE MEDICAL PROFESSIONALS, INDIVIDUALS THAT WERE ON THE COMMITTEE THAT THAT IS ONE OF THE RISKS. ANOTHER RISK, YOU ALWAYS HAVE TO BEFORE ANY INJECTION HAVE TO KNOW THAT THE OFFENDER IN OUR CASE HAS BEEN SEVEN DAYS OPIATE FREE OR IT COULD CAUSE A VERY, VERY SERIOUS REACTION AND WITHDRAWAL PROBLEM.

FREDERICA FREYBERG:

HAVE YOU HAD ANY OF THOSE EXPERIENCES?

JON LITSCHER:

NONE. NO, WE HAVEN’T, AS OF YET.

FREDERICA FREYBERG:

AT WHAT POINT WOULD THE USE OF VIVITROL BROADEN BEYOND THIS PILOT?

JON LITSCHER:

WELL I THINK IF OUR STUDIES SUPPORT THE CONCLUSIONS ON A NATIONAL STUDY THAT SAYS YES, IN FACT THESE PEOPLE ARE REMAINING DRUG-FREE. THEY HAVE THE SUPPORT SERVICES OVER A 12-MONTH PERIOD BECAUSE OUR PROGRAM IS A 12-MONTH INJECTION AND SUPPORT PROGRAM, THAT THEY STAY DRUG-FREE, THEY’RE INTEGRATING BACK INTO THEIR COMMUNITIES. THEY’RE INTEGRATING BACK INTO JOBS. THEY’RE INTEGRATING BACK INTO THEIR FAMILIES AND IT’S A STABLE ENVIRONMENT, THEN IF WE SEE THIS, THEN I SAY IT’S WORTH THE MONEY AND EFFORT THAT IS BEING SPENT. AND I THINK IT IS. WE HAVE ANECDOTAL EVIDENCE TO THAT FACT BUT WE JUST DON’T HAVE THE CONCRETE STATISTICAL DATA THAT SAYS YES, IT DOES.

FREDERICA FREYBERG:

THANK YOU VERY MUCH FOR JOINING US ON THIS.

JON LITSCHER:

IT’S A PLEASURE, THANK YOU VERY MUCH.