About 75 percent of all inmates who come into the Harford County Detention Center suffer from some type of substance addiction, whether prior or recurring, a number that's likely even higher, the jail's warden says.
For the ones who are serious about getting help for their addictions, and not just trying go look good for a judge, the detention center has a new unit to support them.
The Substance Abuse and Behavioral Health Unit at the Harford County Detention Center has graduated two classes of inmates since it started earlier this year in response to the heroin epidemic. Some of those inmates have since been released from jail, others are still incarcerated and are passing along what they learned to new program participants.
"Really, the goal is to provide support for individuals who are ready to help themselves," Waden Michael Capasso said. "We hope when they leave here, they are less likely to not only become a statistic, but to become a burden on the community and commit crimes in the community."
The majority of inmates suffering from dependency are addicted to heroin, Capasso said, but the substance abuse unit is available to inmates with any type of addiction. It focuses not only on substance addictions but mental health as well.
Heroin numbers continue to rise in Harford County; as of Monday, 274 people had overdosed on heroin this year, 51 of them fatally, according to statistics kept by the Sheriff's Office.
"While heroin is the most talked about and certainly is taking lives from us on a nearly weekly basis, there are other substance abuse issues happening in our community," Cristie Kahler, director of media relations for the sheriff's office said. "We are joining together to address the mental health component, as well. It was really imperative for us to bring the two things together and have a program in place at the detention center."
The unit was one of the suggestions of Sheriff Jeffrey Gahler's HOPE group formed shortly after he came into office as one step in addressing the heroin epidemic. HOPE stands for Heroin Overdose Prevention Effort.
The jail program is run by an outside contractor, Correct Care Solutions, that provides all medical services for detention center inmates. The contract is for $3.2 million a year based on an inmate population of 430.
Of that $3.2 million, $62,700 is earmarked for the substance abuse and behavioral health unit, for which Cathy Drennan serves as the director. The unit also includes a corrections officer trained in crisis intervention as well as medical personnel and program providers.
The program is a clinical approach to recovery, but it's not a treatment facility, Capasso said. The jail does not dispense prescriptions such drugs as Suboxone or Methadone that block the effects of opioids.
Each class has included eight to 10 men who live in the only unit being used within the jail expansion that was competed in 2011, but is otherwise vacant. There is no organized unit for women because there is nowhere to house them separately, Capasso said.
The inmates volunteer for the approximate 10-week program and are selected by the unit staff. They have to be serious about getting sober, Capasso said.
"We want them to show signs they're ready to help themselves," he said.
Inmates who are in the unit give up some extra-curricular opportunities, like work details, because of the demands of the unit.
Monday through Friday, the inmates meet as a group from 8 to 10 a.m. They meet nightly with a speaker from Alcoholic Anonymous.
They are expected to present assignments during the group sessions, and are encourage to explore the triggers that precipitate cravings and urges, Kahler said.
"They look at relapse warning signs, the people, places and situations that also start the urge to use again," Kahler said. "Then they begin to explore new coping skills and develop strategies to apply the coping skills."
Inmates use meditation, deep breathing, guided imagery and progressive relaxation, which Kahler said has been beneficial in reducing anxiety without the use of drugs.
"This way, the inmate learns how to use skills within his own brain and body to calm himself instead of through the use of some narcotic," she said.
In addition to the group meetings, inmates can participate in other programs such as START and Mens'33, a faith-based support group for men in early recovery, she said.
Internal staff help inmates make the transition from institutional life to smaller responsibilities, like work details, then work release and, when needed, living arrangements in a sober living community with a network of other men in recovery, Kahler said.
"Our Substance Abuse Unit is a work in progress, but we certainly did not want to wait until we had all the answers before trying to create another path of hope for those in our custody suffering from addiction," Sheriff Jeffrey Gahler said in a statement. "Since beginning this effort, I have received two of the most heartwarming letters of appreciation for what we are doing at the jail from individuals in the program. I am hopeful that for these two young men, and all those that we are able to touch, can continue the path of success they started here."
It's difficult to measure the success of the program, Capasso said, especially since it's so new. Inmates who graduate and are released could relapse, but may not necessarily come back to the detention center.
He has, however, received "very positive" feedback, the warden said, "not only from providers, but from inmates."
"A majority we have received comments from thank us for the opportunity. They recognize their circumstance and are grateful to move to this housing unit," Capasso said. "It's very rare to get positive comments from inmates."
The unit consists of only a small population of the detention center, relative to both inmate numbers and the high percentage with substance abuse issues.
The jail's average daily population in July was 410 inmates - 348 men and 62 women, Capasso said.
Inmates in the general population can participate in any of the support-based volunteer programs, including AA, Narcotics Anonymous, Overcomers (a faith-based program to develop coping skills), peer support groups including mentors from Harford recovery centers and mediation forums, as well as individual counseling with a chaplain and other faith-based leaders in the community.
Inmates also work with a re-entry coordinator to maximize their ability to be successful when they return their community and minimize recidivism, Kahler said.
'It was time to change'
A 40-year-old from southwest Virginia was the first inmate in the program, beginning a sentence just as the unit was starting.
"It was a calling," he said. "It was time to change."
He's been in almost nine months, serving a sentence for "alcohol related issues," he said. He's due to be paroled any day to his hometown in Virginia, and hopes to bring some of what he's learned to recovery programs there. His and the names of other inmates interviewed are not being published at the request of the Sheriff's Office.
"I've learned there are a lot of factors other than just alcohol," he said.
The inmate said he recognized problems from his childhood that have affected him throughout his life.
"I couldn't see them before because I wasn't looking," he said. "I searched myself."
The inmate said he's "got nerves" about getting out, but plans to continue in programs that will help him with his recovery.
"I will put people around me who will help me succeed, not ones who got me put in places like this," the 40-year-old who has three kids and a stepson said.
He's no longer married, a result of his drinking, he said.
He graduated from the program several months ago, but has stayed in the program and the unit not only for himself, but to be able to help other inmates.
As a mentor in the program, he enjoys helping the new inmates.
"For them, the light goes on and you can see they're finally getting it," he said. "And I think, 'man, did I really live like that? And yeah, I really did."
It's a really good program, he said.
"Sometimes I learn stuff from them I couldn't see before," he said. "You have to always be growing. If you stop, you'll fall back to your old life."
Another inmate, a 21-year-old from Baltimore City, is waiting to graduate from the unit. He's been in the detention center for seven months, serving a sentence for heroin distribution. He also used heroin for three years.
He's been in rehab before, but then it was forced on him.
"It was not something I wanted to do," he said. "But I actually wanted to come here so I could take advantage of having a program in this environment in jai."
The program has helped him prepare for when he's released, which he expected to be in February. He doesn't want to use drugs any more, he said, "definitely no."
His relationship with his family has changed, too, since they can see he really wants to change and he's working on it.