by Marina Duane, Jennifer Yahner, Erica Henderson, Malore Dusenbery, and Natalie Gilbert

At the height of the COVID-19 pandemic, in a community with high rates of opioid addiction, a jail in one county in rural Massachusetts showed that treating addiction for people cycling in and out of incarceration can be done better (Partners for a Healthier Community Inc. 2015). In 2020, the Franklin County Sheriff’s Office (FCSO) capitalized on its previously built infrastructure and system partners to offer all three federally approved medications for opioid use disorders (MOUDs) and provide therapeutic counseling remotely to incarcerated people as a critical component of treatment. While the majority of jails in the United States do not offer MOUDs as an option to start or continue treatment during incarceration, the FCSO was able to continue offering all three medications (buprenorphine, methadone, and naltrexone) during the pandemic and to meet diverse clinical needs of people coming into their jail. The FCSO also continued offering individual and group counseling via telehealth throughout the pandemic and shifted to a mix of telehealth and in-person services in 2022. understand what facilitated or hindered its successful application and how clients (that is, incarcerated people) and the professionals supporting them perceived the effects. Our findings fill a critical gap in knowledge about whether counseling can be effectively delivered via telehealth in correctional settings. We hope this brief provides useful knowledge to other jails across the country on how to shift to a treatment philosophy. In addition, we hope it gives other localities some ideas on how to create an infrastructure that is conducive to treating opioid use disorders (OUDs) with the dignity and prowess required to address the complexities of the unaddressed mental health needs that often accompany addiction. The results of this study are promising, as illustrated in the following highlights:  Over a decade ago, FCSO leadership set a vision and a strategy to become a nationally recognized facility that prioritizes high-quality behavioral health treatment rather than simply “warehousing” people. Such transformation took time, but our findings suggest that at the start of the COVID-19 pandemic, most FCSO staff recognized their important role in curbing high rates of opioid addiction in Franklin County. Staff made significant strides in expanding behavioral health treatment and therapeutic counseling as its critical component.  By 2020, the FCSO was offering all three modalities of federally approved medications to treat opioid use disorders as continuation and induction options. While most jails in the United States still do not offer any MOUD treatment, FCSO provides a range of options to meet the complex needs of people with OUD diagnoses wherever they are in the recovery stage.  Our evaluation demonstrates ways in which the FCSO was able to provide high-quality one-onone counseling remotely at the height of the COVID-19 pandemic. For example, out of 31 surveyed clients, 90 percent reported a strong bond with their counselor, also known as therapeutic alliance, and 84 percent rated the quality of telehealth counseling as “good” or “excellent.” Furthermore, 87 percent of respondents said that counseling via telehealth helped them more effectively deal with problems in their lives, including addiction.  Although some FCSO behavioral health staff we interviewed reported it was challenging to do trauma work in jail with people struggling with addiction and who often get released quickly, overall, staff praised the FCSO’s decision to offer high-quality counseling and maximize clients’ time in therapy to address important mental health needs.

Washington, DC: The Urban Institute 2023. 17p.

By Brian Elderbroom, Leah Sakala, and Ammar Khalid

Utah adopted criminal justice reform legislation (H.B. 348) in 2015 to curb prison population growth and invest in behavioral health treatment, including reclassifying first and second drug possession convictions from felonies to misdemeanors. Our analysis finds that Utah successfully reduced the number of felony drug possession convictions, with a 71 percent drop between 2014 and 2018. Additionally, people spent a combined 105,011 fewer days in prison for drug possession in the two years following reform than in the two years before. Furthermore, reconviction and imprisonment rates for people with drug possession convictions were low prior to the policy reform and remained unchanged afterwards. However, Utah’s prison population is again growing, arrests for drug possession are rising despite declining arrests overall, and prison admissions for possession with intent to distribute offenses are increasing. This brief offers recommendations that Utah policymakers can consider to build on prior reforms, address additional prison population growth, and continue to invest in more effective public safety solutions.

Washington DC: The Urban Institute, 2020. 19p.

By Erik Luna and Weldon Angelos

Marijuana laws in the United States vary by state, with some states allowing recreational use and others only allowing medical use. At the federal level, marijuana is still illegal, however, banned as a Schedule 1 substance under the Controlled Substance Act. The disconnect between state laws and federal laws is growing. As of December 2024, 39 states allow for medical use of marijuana and 24 states allow for recreational use, while a proposed change in federal rules would reschedule marijuana from Schedule 1 to Schedule 3. With the laws constantly evolving, and calls for legalization at the federal level growing louder and louder, what happens to the people still affected by the federal war on marijuana at the twilight of national prohibition? This white paper proposes clemency criteria for non-violent, federal marijuana convictions. It concludes by offering next steps for both executive and legislative action. With the President’s leadership, this Administration and Congress can assure that individuals haunted by marijuana arrests and convictions will finally have the clean slate they deserve.

Arizona State University Sandra Day O'Connor College of Law Paper No. 5199528, 43p.