Gripped by opioid withdrawal, Benjamin Santiago was violently unwell when he stepped into San Mateo County’s Maguire Correctional Facility final fall.
At 44, he had been utilizing illicit opioids for greater than twenty years, bouncing out and in of juvenile halls after which county jails throughout the Bay Space for promoting medication — together with to his personal dad and mom — to pay for his dependancy.
On that cool November day, the jail workers interrupted that downward cycle, providing Santiago a medicine that may blunt his opioid cravings and drastically enhance his possibilities of staying sober, staying alive. For the previous two months, doses of buprenorphine have taken the tooth out of Santiago’s intense cravings. He’s began to ascertain a brand new course for his life when he’s ultimately launched.
“This is the first time I’ve ever thought about being sober when I get out,” he mentioned.
Amid an epidemic of drug overdoses that’s lastly displaying indicators of slowing in California, public well being specialists are bettering entry to drug therapy in prisons and jails, which are sometimes awash in fentanyl and different smuggled medication. Nationally, drug and alcohol overdose is a prime explanation for loss of life in jails and the main explanation for loss of life for many who have been lately launched.
Hundreds of different individuals imprisoned in county jails might quickly have entry to such ‘medication assisted treatment’ within the subsequent two years. On the path of Gov. Gavin Newsom, the state’s Medicaid program is starting to choose up a part of the tab for the expensive therapy. As an illustration, a single shot of buprenorphine prices greater than $1,200 and cuts cravings for a month. State guidelines would require all jails to supply inmates with a collection of dependancy therapy choices by October 2026.
The change is a part of CalAim, a broad enlargement of the the state’s well being care supplier for low-income residents, Medi-Cal, to cowl non-traditional providers similar to housing and care for many who are incarcerated.
After California prisons started offering opioid dependancy drugs in 2020, overdose deaths of imprisoned individuals declined by 58%, in line with the California Division of Corrections and Rehabilitation.
“These medications are life and death for someone coming out of custody and in that state,” mentioned Mary Taylor, who leads San Mateo County’s push to make dependancy therapy medication extra out there on the San Francisco Peninsula, together with in county jails.
A slew of challenges hamstring the flexibility to ship dependancy treatment in jails, Taylor and well being officers mentioned. The necessity is huge, however logistical issues hound efforts to maintain people who find themselves imprisoned on an everyday schedule of treatment. It’s unclear if correctional well being workers will be capable of make good on California’s effort to make the very important drugs extra out there.
Below the state’s enlargement of care, workers at correctional amenities just like the one in Redwood Metropolis are required to evaluate inmates for opioid dependancy and, in the event that they qualify, present choices for therapy. That features Sublocade, the injection of buprenorphine, an opioid dependancy therapy authorized by the U.S. Meals and Drug Administration, that Santiago receives month-to-month to quell his cravings.
Santa Clara County started complying with the brand new state guidelines in October, and San Mateo County will get on board in February, jail well being officers advised Bay Space Information Group. Contra Costa County officers mentioned roughly 150 individuals already obtain the drugs day by day in county jails, and they’ll totally implement the adjustments by the 2026 deadline.
With the brand new help from the state, Darryl Liu, an analyst at San Mateo County Correctional Well being Providers, mentioned he plans to proceed his years-long aim of ramping up entry to buprenorphine and different opioid dependancy drugs.
“CalAim has been a huge godsend,” Liu mentioned.
Habit treatment, although life-saving, is pricey, he mentioned. San Mateo County spent greater than $116,000 on that treatment in jails in October 2024, the newest information present. The county has already acquired a $4 million grant from the state well being company to begin scaling up its treatment program and pay for different prices, Liu mentioned.
A former police officer in Los Angeles, Liu mentioned an expertise on the job made him depart regulation enforcement and focus as an alternative on treating dependancy. When a intercourse employee arrived on the hospital determined and looking for therapy, he mentioned he needed to arrest her after nurses searched her belongings and located onerous medication.
“I didn’t think that was appropriate,” he recalled.
At Maguire Correctional Facility, Liu has centered on shoring up entry to treatment assisted therapy since 2018. At that time, three individuals had been receiving the therapy, he mentioned. By December 2024, 46 had been receiving buprenorphine, and Liu mentioned that quantity will enhance with the brand new Medi-Cal help.
Final month, Daniel White lifted up his pink jail uniform to point out a small node of treatment the dimensions of a walnut that protruded from his stomach. It was a mass of Sublocade, which dissolves slowly over the course of a month because it time-releases buprenorphine.
White, 44, has lengthy relied on an oral model of buprenorphine to remain sober. Like Santiago, he’s spent most of his grownup life behind bars.
“It all stems from drug use,” White mentioned.
Though Liu and Taylor say they’ve made progress, each acknowledged that their efforts are solely reaching a fraction of those that want treatment to deal with opioid use issues.
Statewide, two-thirds of individuals in jails and prisons require some sort of therapy for a substance use dysfunction, in line with the California Division of Well being Care Providers. In December, 3% of the county’s jail inhabitants was receiving Sublocade, in line with information.
“I always feel like we’re not doing enough,” Taylor mentioned.
For Santiago, although, the longer term is trying unusually shiny. On a latest Monday at Maguire, the San Francisco native mentioned he’s savoring a life with out the urge to make use of fentanyl or different illicit opioids, due to his month-to-month shot of Sublocade.
Currently he’s imagined beginning a brand new lifetime of sobriety along with his girlfriend, who’s homeless and utilizing medication within the Tenderloin neighborhood in San Francisco.
The aim?
“A better life,” he mentioned.
