For some addicts, jail has become de facto treatment
FAIRLESS HILLS, Pa. – Jason Wasylenko gave the prison employee his sizes and was handed a pair of jeans and a chambray shirt.
The 32-year-old gathered his belongings – some art made by other inmates, sports posters, a TV and stereo, books and knickknacks – and left his cell of the last three years.
He went to medical, then the business office. He filled out paperwork and verified his identity so the guards at State Correctional Institution at Rockview, in Centre County, knew they were releasing the right person. He’d been through it all several times before.
Still, he was anxious.
Jason was accustomed to life behind the wall. He knew what to expect. And he knew what to expect after he was released, too – both good and bad.
“When you go in and you’re putting all your baggage at the curb, when you come out that baggage is still sitting there waiting for you,” he said. “And some people’s bags are a lot heavier or lighter than others.”
For as many as 80 percent of inmates, including Jason, that baggage includes problems with drug use, multiple national studies have shown. But with limited access to treatment on the inside or tools to deal with addiction on the outside, about 95 percent use again once released. Sixty percent to 80 percent commit new crimes.
Locked in that cycle, many, like Jason, end up back behind bars. And jail becomes their de facto treatment.
“We know for a vast majority of them, if it was not for their addiction, they wouldn’t be in our facility,” said Bucks County’s Director of Corrections Chris Pirolli.
Realizing that inmates could use recovery skills, Bucks County launched two therapeutic recovery programs in both the male and female sections of the prison to better respond to the opioid epidemic. While the women’s program is only two months old, the men’s program has been serving 52 inmates at a time since a $300,000 county grant funded it in 2016.
In Bucks County, 245 out of the 815 inmates in both jails are in some kind of drug or alcohol treatment program, attending AA or NA meetings, group therapy or other designated programs, correction officials said. Although about 75 percent of the jail population faces addiction issues, not all of them want treatment, and for the majority of them the programs are voluntary.
“They are not beating down the doors to get to this,” said Mike Palumbo, drug and alcohol specialist supervisor at the Bucks County Correctional Facility. The waiting list for the program rarely extends to 10 names. Also, certain violent and sexual crimes eliminate offenders from eligibility.
But demand is growing, especially among those who have never been in a recovery program, Palumbo said.
“Jails often pick up what society doesn’t offer, when society doesn’t offer treatment and then jails get people who aren’t treated,” he said. “We could just give them three meals and keep them safe. But that is how we get a repeat customer. We are trying to find a way to intervene and put in a stopgap.”
In addition to the programs, inmates who are medically cleared and struggle with an opioid addiction are offered Vivitrol, a drug that blocks the effects of alcohol and opioids. Also called naltrexone, the drug is offered along with the HOPE treatment and recovery program, which operates out of a separate area of the prison.
Vivitrol manufacturer Alkermes provides the shots for free. Then, the county corrections department works to have participants stay on the treatment for 11 months after they’re released, often by helping them enroll in Medicaid so they can afford the shots, which go for about $1,000 each.
Last week, the Pennsylvania Department of Corrections and Department of Human Services announced a plan to streamline the process for applying for medical assistance for inmates being released from state facilities.
About 10 percent of the 20,000 inmates released from state facilities each year qualify for medical assistance because of chronic medical or mental health diagnoses or substance use disorders, according to the DOC, but the process of applying “has proven both labor intensive and time consuming.”
“It is in the community’s best interest to have those that leave succeed,” Corrections Secretary John Wetzel said. “Ensuring they have access to medical and mental health benefits is essential to a successful transition back to the community.”
Patricia Davis, supervisor of the Bucks County’s Drug and Alcohol Treatment Section, said Vivitrol is just one tool, and that medications should be combined with behavioral and therapeutic counseling. They learn about repairing relationships, basic life skills and phasing back into the community drug-free.
“If it (the program) can help change their thinking, it can change their behavior,” she said.
For women, Bucks County’s HEART program, funded through a state grant, offers additional services to help those inmates, who often face higher instances of trauma and abuse, she said. Along with therapy, parenting and life skills are addressed. Both programs, offered in phases, help transition inmates to after-care programs. The prison enrolls departing inmates in the state’s Medicaid program, so that upon release they can get treatment.
Palumbo said only about 20 percent of Bucks County prisoners insist upon transitioning to a treatment or recovery environment before their release.
Providing treatment in jails and prisons has been found to reduce recidivism rates in national studies, but the things that improve the outcomes for inmates are the same as for the general population, said Ken Martz, special projects consultant for Gaudenzia Inc., who has worked with prisons in Maryland and Pennsylvania.
“Study after study, decade after decade, the No. 1 predictor of outcome is length of treatment,” said Martz, who also served for several years as special assistant to the secretary of the Pennsylvania Department of Drug and Alcohol Programs.
“Treatment occurs in the context of a relationship,” he said. “Where I begin to know that I can trust you and can begin to share the secrets of my shame and trauma, my abuse history. That I’m not going to do on day one.”
For residential or outpatient treatment, the National Institute on Drug Abuse recommends at least 90 days, and longer courses for better outcomes. But also of importance, Martz said, is intensity of treatment, and care that continues into the community.
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On the cold March day Jason was released, his mother, Sheryl Robas, and his younger sister, Nicole Wasylenko, were waiting for him. Nicole had picked out clothes and packed them in a duffel bag with some toiletries.
They stopped at the first gas station they passed on the way home to Falls so Jason could put on his own outfit, rather than the prison-issued fare, and “blend back in with society.”
But he knew that would be harder than just changing his clothes.
Jason started using marijuana and prescription drugs as a teen, and then moved on to heroin when his father died shortly after he graduated from high school. He went to detox and rehab about 10 times when he was younger but it was always for the wrong reasons.
Heroin changed everything, including what Jason would do to get it and avoid withdrawal. Jason started stealing from retail stores but it didn’t cut it after a while. He started selling.
“My out was, if I sell (heroin), I’ll always have it. So then I’ll be making the money for my addiction and I don’t even have to go anywhere. I’ll have it right here and people will come to me,” he said. “I have the best of both worlds. I feel like I’m the man cause everybody’s calling me up asking what’s up, and at the same time the countdown’s not on my mind as much.”
At one point, Jason’s mother suggested he go live with family members in Colorado.
“The morning we leave I’m in my bedroom and I’m getting high,” Jason said. “I’m using needles at this time, so I’m shooting heroin.”
He “white knuckled it” when he got there. And it stuck. He stayed sober for a year and a half.
“That was the most productive and happy time of my life,” he said. “I was 21, 22 years old. I had my own apartment. I was paying my own bills. I was independent, self-reliant. I was living the dream. I was a success story at that time. I made it. But yet again, you get cocky or just complacent.”
Jason moved back home. He’ll never forget that first time he relapsed.
“It was in that same exact bedroom. I remember as soon as I put it together and used, thinking to myself, ‘Wow, everything I just accomplished over the last 18, 19 months is completely gone and I’m right back where I was,” he said. “All that just seems like a dream, like it never happened, like it’s just been completely erased and here I am sitting in the same exact spot on my bed with a needle in my hand.”
Eventually, detox and rehab was replaced by jail. It wasn’t treatment, but it took away the option to use, and he couldn’t sign himself out.
“Nobody ever wants to go (to jail) – unless you really have no place to go, and sadly, some people do that,” Jason said. “But in the back of your mind you know from past history once you start using again that’s going to be the end result.”
This was Jason’s fourth stint in state prison. He’s spent a total of about 11 years behind bars since 2003, all on drug-related charges.
“I said to him, ‘I don’t know what your favorite color is. I don’t know what your favorite food is,’ “ Sheryl said, recalling a past conversation. “It’s sad because I don’t know my son.”
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Bucks County’s Davis said she knows many parents are grateful their sons or daughters get jail time.
“I get calls from parents, saying, ‘Oh my God. I’m so glad.’ Parents can get a good night sleep,” she said.
One Newtown Township father understands that feeling of relief. In fact, he turned his son into authorities after he broke into the family home and stole to feed his addiction. His son is now in Bucks County Correctional Facility for his crimes.
Tom, who asked that his last name not be used, is trying to get his son moved into a rehabilitation facility before being released.
“There should be (a) coordinated effort to get these released prisoners to addiction services on that day of release, pronto,” he said. “Our son has stumbled two to three other times in the past when released from prison.”
Tom said his son has never had an opportunity for treatment or recovery programs in prison.
“We just don’t want our son to die and we are looking at another avenue to try that we haven’t tried before and that would be straight from prison to inpatient help under parole supervision,” he said.
While Bucks County jail programs and community partnerships aimed at helping those with addiction continue to grow, prisons are not meant to replace treatment and rehabilitation programs, Palumbo said.
“We are not a rehab facility, and we don’t want to give that perception,” said Palumbo. “But we offer therapeutic intervention for those with substance use and abuse it.”
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It gets easier each time, Jason said of incarceration. Even the withdrawal.
“Because I know what to expect,” he said. “If I’m in the cell that’s it, it’s over with. Mentally, you kind of accept that fate of knowing you’re just going to be sick.”
People find ways to make themselves feel better, Jason said. Some take more showers because the hot water helps to loosen the muscles. Some rock themselves to sleep.
“Everyone has their own little thing that they use to help themselves get through it,” he said.
In prison, Jason had access to 12-step fellowship meetings and drug education classes, but he thought the curriculum was outdated. He would have benefited from more individualized, hands-on treatment, but there aren’t enough employees, he said.
“Through all the times I’ve been in prison I’ve taken some type of a drug education or some type of treatment, therapeutic-type program,” he said. “But it’s hard for them, they don’t have the time to figure out everybody individually so they find a general theme that can touch a little bit from every person and trying to use that as a guide to doing the right thing. But it doesn’t work.”
Treatment options in prisons vary. There is no uniform requirement for providing rehabilitation or treatment in the county program, Pirolli said. The bulk of the funding for existing Bucks County programs has come through the county. At the Bucks County jail, there is no limit to how long an inmate can be in the treatment program.
“We are only bound by their sentence; we can have them for longer than 28 days, and they won’t get dismissed by insurance,” said Palumbo.
Davis said the jail’s drug and alcohol programs got a boost with a grant from the Centers of Excellence, which allows case managers from area centers to go into the prison to help people with opioid-related substance use disorder stay in treatment and receive follow-up care after they are released.
“Our job ends when they walk through the door, but now they can check in with their case managers who can continue to mentor them,” said Davis, adding that 80 percent of inmates are referred to some type of treatment when they are released.
The county is only now starting to track recidivism rates, and information on the effectiveness of the programs, including the Vivitrol shots, cannot be determined, Pirolli said.
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This time is different, Jason and Sheryl agree.
Spending his 30th birthday in jail marked a turning point.
“I looked back on the last decade and I’m looking at 16 months that I had on the outside out of the last 10 years,” he said. “Life in general, as age progresses, it tends to stop giving you things and starts taking them away.”
It’s already started, he said. Several family members on his father’s side died while he was behind bars.
“He missed so much out of this decade. He missed his sister’s graduation from high school, he missed her graduation from Temple (University). He’s missed weddings, he’s missed all of these children back here,” his mom added, pointing to portraits on a dresser in the dining room of her young nieces and nephews.
A month before Jason was released, Sheryl was diagnosed with Parkinson’s disease.
“I told him look, you have to grow up – you’re not 18 anymore, you’re going to be 33, you’re a man. I need your help,” she said.
Jason can’t get back the time he missed, but he’s been spending a lot more with his family now.
He’s been attending activities with friends who are active in 12-step programs. He was able to secure health coverage, and he got a job that he enjoys as a trainer in a local gym.
“They’re going to give me a chance,” Jason said.
That’s been a big barrier in the past. When filling out applications, he’s struggled with whether to check the box acknowledging that he’s been convicted of a felony. He always asked for an opportunity to explain.
“I would just tell them,” he said. “I’m not a bad person – I couldn’t be further from it – I just have a drug problem. That’s what it is.”
He’s been doing well for the last two months, he said, but “all it takes is that one time.”
“I know what’s going to trigger me. I know what I have to do. It comes down to that choice,” he said.
“God forbid, if I ever cross that bridge I would hope that I would be strong enough to just say something and try to nip it right then and there and not let it progress. I know in the past that when that would happen, a lot of it’s like a pride thing, like you’re embarrassed,” he said.
Jason and his family have been down this road before, but he said he feels like he’s at a crossroads.
“I could either go right and live the right lifestyle – be there for my family, be a productive member of society. Or, I could go left and I know if I decide to go left that that’s going to be my lifestyle,” he said. “This is kind of it.”