August 17, 2022

Opioid Use Disorder is a chronic disease that affects correctional health priorities for the Fairfax County Sheriff’s Office and its Adult Detention Center (ADC). Over 70 incarcerated men and women (12% of the population) are currently participating in the Sheriff’s Office Medication for Addiction Treatment (MAT) program, which offers evidenced-based treatment for opioid use disorder (OUD) in the ADC and vital wrap-around reentry recovery supports at release.

The agency launched its voluntary MAT program in 2020, prescribing and administering Suboxone, an oral form of buprenorphine. Buprenorphine weakens intoxication from other opioids, prevents cravings and withdrawal symptoms, and allows individuals to transition from a life of addiction to a life in recovery. Individuals actively engaged in the program can continue to receive medication for the duration of their time in the jail if clinically indicated. The goal of the Sheriff’s Office MAT program is to reduce overdose deaths and lower the rate of recidivism.

While the Sheriff’s Office has experienced much success with the MAT program, a challenge with administering an oral medication is ensuring the substance is not diverted inside the jail.

In June 2022, the Sheriff’s Office became the first jail in Virginia to begin a pilot program using Sublocade as another medication option to treat OUD. Sublocade is an extended-release buprenorphine that is injected subcutaneously once a month, an alternative to the daily dose needed for Suboxone. Two inmates started Sublocade in June and have been positive about the medication with no reported adverse effects. In the following weeks, additional MAT-eligible inmates have become interested in participating in the Sublocade pilot program.

Nurse Practitioner Cindy Wang has taken note of the positive response to Sublocade. “One patient told me he appreciates being able to make one choice every month rather than having to decide every day to get treatment,” said Wang. “Overall, our MAT patients feel more secure. They don’t want to return to the community and die from an opioid overdose.”

In addition to reducing the burden of taking daily medication, monthly treatment with Sublocade eliminates interruptions due to transports to, and subsequent returns from, other jails for court. Equally important, a monthly injection reduces medication administration process time and removes the opportunity for medication diversion. Inmates can engage in the treatment process by selecting which treatment approach might work better for them.

From its inception in Fairfax County, the goal of MAT was not just to have a program but to have a successful program. This has meant modifying the program as needed and adding services and support. The addition of Sublocade as a treatment option will contribute to the ongoing success of the Fairfax County Sheriff’s MAT program. The program does more than change lives. It saves lives.

For more information about the MAT program, please contact Sahana Karpoor, Sheriff's Office Behavioral Health/MAT Program Manager.