Carbon County officials are fine-tuning the prison’s medication assisted treatment program to make better use of funds for a program to help those incarcerated who are addicted to drugs or alcohol.

On Thursday, the board of commissioners, in a 2-0 vote, approved limiting the MAT program at the county correctional facility to injectable qualifying medication to eligible inmates. Commissioner Wayne Nothstein was absent.

Commissioner Rocky Ahner said much discussion took place between the prison board, county correctional facility staff, Carbon-Monroe-Pike Drug & Alcohol Commission and Prime Care, the company hired by Carbon for medical at the prison. Ahner said the county prison board and commissioners feel the program should use injectable medications to help with drug and alcohol addiction, rather than the daily pill forms of the medications.

“We’ve been debating on this on what we’re supposed to give the inmates for rehabilitation through the MAT program at our correctional facility,” Ahner said. “There have been issues, but the less we use pills within the facility, the better off we are.”

He cited the extra hours on correctional officers when giving daily pills instead of the once-a-month injections.

For each inmate taking the oral medication, a guard must then watch that inmate for approximately 20 minutes to make sure that the medication isn’t hidden or “cheeked” instead of swallowed.

Multiply that by approximately 30 inmates getting the medication and that takes at least two correctional officers away from other duties for a total of 10 hours a day, every day.

Injectables, he said, would cut that time down to about two hours every 30 days.

Ahner said that he feels injectables, which cost about $1,000 for a month supply, would save the county money when factoring in the salaries of the guards tasked with watching inmates for the pill form.

Plus, the county is required to provide inmates who are released with the medications for three months after incarceration, and the pills could easily be sold or just discarded instead of helping the person stay away from the addiction.

“We’re trying to get people out the (prison) door and on the right path to having a successful life,” Ahner said. “I know there has been some lawsuits that are coming up through different things, but I don’t see how there could be a lawsuit on us trying to help people. ...

“People need to realize when somebody comes back into the facility, and we all talk about recidivism, it’s $140 a day to house that inmate then you have to take care of their medical, you have transportation to hospitals, what if they are on dialysis or they need an operation. One inmate could wind up being $100,000. ...

“I think it is our choice on what we want (to provide inmates with to treat addiction). This is being done solely on the safety and security issues at our prison.”

Carbon County District Attorney Michael Greek, who serves as the president of the county prison board, said the issue came up after the program began in January because officials learned that no inmates were choosing the injectable option.

Carbon County received approximately $114,000 in grant funds for the injectable Vivitrol, but it wasn’t being used in the MAT program because inmates were being given the choice on what they wanted. They also earmarked funds from the opioid settlement to cover costs for treatment of inmates with opiate addiction through this program.

“What we envisioned is not what was taking place in the prison and it creates a burden on the personnel, as well as our guard staff who have to consistently watch and make sure these things are ingested rather than where you have the injectable, when it’s done, it’s done. ...

“Our office was involved in incidents at the prison and it (oral medication given through the MAT program) gives rise to other criminal activity within the facility. This may curtail that and I think it’s safer just to have it. ... There needs to be a protocol which was never established when it went into effect but it shouldn’t be purely within the inmate’s selection of what they perceive they want. It’s a correctional facility. It should be this is what we’re prescribing.”

Greek said that there may be some exceptions in the program when the oral form is appropriate for the inmate, however that is up to the medical staff and Drug and Alcohol to best determine those exceptions rather than giving inmates a “cornucopia or buffet line of every type of medication that’s provided.”

Sheriff Dan Zeigler, also a member of the prison board, added that you have to keep the goal in mind of helping people. The injectables allow the county to do that because it allows them to treat a person while they are incarcerated, as well as a start for a best chance for success after leaving the prison.

“Having to take a pill every day is hard to maintain, but when you’re getting an injectable that lasts 30 days, potentially, their level of success and being able to be rehabilitated in the community is really what the goal is. I think adopting this program with the injectables does that,” Zeigler said.

The board said that the policy now goes to the county solicitor for review before it goes into effect.

Robert Frycklund, solicitor, said that there are some changes he already sees need to be made in the policy, but said that such a policy is the intersection where medicine meets law and they are trying to find that balance to best serve both sides.

He said that while he would like to have everything finalized for the county within a few days, he believes it will be a few weeks before the final draft of the policy is completed and approved by all involved and put into effect.

Carbon County implemented the MAT program at the prison at the beginning of the year with the partnership with Carbon-Monroe-Pike Drug & Alcohol and Prime Care.

A meeting was held to outline what is involved once the program was up and running and officials learned at that time that injectables were not being utilized at the prison because inmates were choosing oral options instead.

In March, the county prison board again met with Prime Care to discuss this and looked at stepping back until a policy outlining what the county’s program should be to best benefit the inmate population and the demographics for those who qualify for this medication.

At the April prison board meeting, the county had not yet received the new proposed policy and was continuing to look into the matter.