Durham Jail First in South to Provide Naloxone to Released Inmates


Durham Jail First in South to Provide Naloxone to Released Inmates


In April, the STARR Program, located in the Durham County Detention Facility, became the first in-jail Substance Use Disorder Treatment Program in the U.S. South to distribute overdose reversal kits to people to clients as they are released from jail. Thanks to years of advocacy effort by Randy Tucker, Director of the STARR program for substance users, and Kay Sanford, liaison for NCHRC, the first inmates are set to receive their kits this month.


The statistics on overdose deaths for people recently released from jail or prison are appalling. Some studies report that formerly incarcerated people are over 100 times more likely to die of a drug overdose in the first two weeks post-release than the general population. Last year alone, four people died of drug overdose soon after being released from Durham Detention Facility, one within 24 hours.

“People coming out of jail [and prison] are at the highest risk of death,” says Randy Tucker. “This effort is about connecting them to the right tools and the right training to prevent some of those deaths.”


The harm reduction class that Kay teaches provides the vital information that could save the life of anyone who uses opioid or knows people who use opioids and are at risk of overdose.


“Too many people are needlessly dying from opioid and other drug overdoses,” says Kay. “Knowing what to look for, what to do and having the naloxone on hand to reverse potentially life threatening overdoses will save lives.”


About 40 inmates per month participate in the STARR program for substances users, which includes intensive evaluation, group therapy, and classes such as Kay’s class on overdose response and naloxone use. Naloxone is a safe and effective medicine that reverses opioid overdose. Any person who attends the training and wishes to receive a naloxone kit provided by NCHRC can request one. On the day of their release, a STARR staff member will meet them to hand them a kit as they leave the facility. The program incurs hardly any cost, as the overdose prevention training and the kits are provided free of charge.


The process of getting approval for the program was long and arduous at times. There was pushback from drug courts and jail administration to providing any medication to inmates who struggle with addiction whether it be naloxone or medication assisted treatment (MAT) such as methadone or buprenorphine.


“For a long time our drug courts wouldn’t accept anyone on MAT even if they could pay for it themselves,” says Randy. “Lately they are more open to talking about it. The change comes as a result of a perfect storm of things. The feds are starting to withhold funds from drug courts if they don’t do everything in the best interest of the client, we are looking at applying for a re-entry grant where part of the requirement is to provide overdose reversal information, and NCHRC has already been providing the training and kits to the community.”


Survey results from Kay’s class indicate that 12% of the inmates in the STARR program have overdosed on opioids; 37% have witnessed an opioid overdose; 77% feel comfortable using naloxone to reverse an overdose; and 76% want a naloxone kit when they are released. 


The Durham county jail is one of only three in the state that offer substance use treatment to inmates (the others are in Buncombe and Mecklenburg counties) and one of only five that offer overdose prevention training (along Buncombe, Guilford, Orange, and Wake). For Randy and many others, that so few jails would offer assistance to substance users (who make up the majority of the inmate population) is tragic. 


“I would like to see the criminal justice system embrace addiction treatment medications instead of run from them,” says Randy. “If you really want people to recover and not wind up back in the system, we need to connect them to treatment and services both inside and outside the jails.”


His advice to other incarceration facilities, especially those who do not have programs like STARR, is to start by reaching out to organizations like NCHRC to provide overdose prevention training to inmates. Once that conversation is started about the need for overdose prevention and naloxone for high-risk populations, then logistics such as naloxone storage and how to get it to inmates can be worked out.


“The criminal justice population need the most help because they have deficits in every area of their lives,” says Randy. “If we don’t pay for treatment or medication through the front end, we end up paying even more through the back end in terms of emergency room costs, crime and recidivism.”


For more information on how to provide overdose prevention training at your facility or to set up a naloxone distribution program for inmates, please contact Robert Childs at Robert.bb.childs@gmail.com or Tessie Castillo tswopecastillo@gmail.com.