Bexar County officials announced on Tuesday plans to expand the adult detention center’s mental health services through a pilot program that, if approved, will offer a medication that reduces cravings and blocks the ability for inmates battling opioid and alcohol addiction to get high.

The Medication Assisted Treatment Pilot Program will provide inmates who are detoxing from heavy drug and/or alcohol use with four months’ worth of Vivitrol, an extended release prescription drug meant to be taken once per month, beginning 60 days before they are released, officials said. Once released, the individual will receive two doses of Vivitrol to be administered at home.

Providing the medication, which costs $1,000 per dose, would be made possible by a grant from Governor Greg Abbott’s office, applied for by the Joint Opioid Task Force, said T.J. Mayes, task force chair and junior partner at Phipps Deacon Purnell, PLLC. The 18-month program would help at least 65 local inmates, he said.

Bexar County expects to receive $385,000 in funding, though the funding has not been officially announced.

There are currently three medication-assisted treatments approved by the U.S. Food and Drug Administration for the treatment of opioid dependence:  buprenorphine, methadone, and naltrexone. Vivitrol is the extended release form of naltrexone, which received federal approval to treat opioid dependence in 2010.

Vivitrol is non-addictive and non-narcotic, which makes it appealing to jails and corrections departments, some of which may not be comfortable with other treatments, Mayes said, noting that the Joint Opioid Task Force recently toured a Philadelphia jail that is distributing the medication. “Studies show that in detention settings it helps reduce the risk of overdose and also reduces recidivism,” Mayes said.

Officials said Bexar would be among the first county jails in Texas to offer the drug, which will be dispersed to inmates by case managers who will also assist with social services, housing, and employment once they are released on community supervision and under the jurisdiction of the court.

Harris County Jail unveiled a similar program in 2017, which provided Vivitrol to eligible inmates in addition to counseling and case management services.

The expansion of treatment options is the latest effort by the task force to address the opioid epidemic in Bexar County, which has the third-highest rate of opioid-related drug overdose deaths per capita in the state of Texas, according to the San Antonio Metropolitan Health District, and almost a third of the state’s cases of neonatal abstinence syndrome, a disease in which babies are born with opioid withdrawal because of their mother’s opioid use during pregnancy. 

The County is also seeking $1 billion in damages from opioid manufacturers and distributors for the impact the opioid epidemic has had locally, in a trial set for October.

In addition to the option of taking Vivitrol during and after incarceration, Bexar County inmates have the opportunity to leave the jail with doses of the opioid-reversal drug Narcan, the nasal spray version of Naloxone, to carry with them upon their release, made possible through a recent grant received from the Substance Abuse and Mental Health Services Administration. 

“The time that someone is most vulnerable to overdose is when they are leaving incarceration,” Mayes said. “You can really make a dent in the overdose issue by providing resources and ongoing support to this population.”

Roseanna Garza reports on health and bioscience for the San Antonio Report.