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Drug treatment programs and jails work together to help inmates

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Tony Fondie and Gina Evans stand for a portrait.
Minnesota Adult and Teen Challenge's Tony Fondie and Gina Evans stand for a portrait outside of their offices in south Minneapolis on Friday, August 10, 2018.
Evan Frost | MPR News

Tony Fondie drives to jails across the state to pick up inmates as they're released. During the sometimes long drives back, he shares his own story with the passengers.

"Methamphetamine, meth cook: I loved everything about it at the time," Fondie said. "I was enslaved by them."

Fondie was incarcerated for making or possessing meth in 2003 and 2008. He'd enrolled in treatment to get out of prison, but sobriety didn't stick.

"You get out there and things were happening that I didn't plan on happening," Fondie said. "I got discouraged, started using again, and then I came back again when I got in trouble in 2014."

After he was released that final time, Fondie went to the Minnesota Adult and Teen Challenge long-term treatment program. This time he stayed with it. He now works shepherding inmates from jails to the treatment programs.

"There is hope, and you've got to make a choice," Fondie tells the passengers. You've got to make that choice for the rest of your life, and then you've got to do it a hundred times a day."

Amidst an opioid overdose epidemic that now claims almost 50,000 lives each year in the United States and rising rates of meth use, county jails and treatment programs have started to work more closely together. Teen Challenge is just one organization working directly with inmates in Minnesota's 87 counties to try to help get inmates access to treatment, and to avoid the danger of overdose faced by people leaving jail.

Interrupting the cycle of drugs and jail

Ramsey County Sheriff Jack Serier has seen law enforcement's approach to drug offenders begin to change over his three-decade-long career.

"We've kind of grown up in law enforcement to understand that, yes, there are dealers and people creating these drugs that we need to deal with," Serier said. "But when it comes to the end user, our role is to help them find hope and help them find ways to get out of addiction."

The Minnesota Department of Corrections estimates that about 90 percent of inmates in state prison could be diagnosed as chemically abusive or dependent. Getting help for drug dependency or addiction can be more difficult in a county jail setting than for those in the state prison system, which operates its own treatment programs. The average stay in Ramsey County jail is just six days.

Serier said his department has staffers who can assist inmates dependent on opioids or other drugs while they're in custody, but they've also built relationships with groups outside the jail.

"For some folks, especially those who say, 'I need that help and I need it right now,' we're going to start to connect them," Serier said. "But really the long-term needs they have are going to have to be taken up outside our facility."

Studies show inmates who receive drug treatment and aftercare were less likely to go back to jail later.

That's where treatment programs like Minnesota Adult and Teen Challenge take over. They now do outreach in about two-thirds of the county jails in the state, including Ramsey County's facility.

Tim Walsh, vice president of long-term recovery and mental health for Teen Challenge, said about 40 percent of the people going through their treatment program have some sort of legal conditions tied to their use of drugs or alcohol. Teen Challenge's 11 treatment facilities across the state serve about 850 people a day.

"If they're coming here just to satisfy the conditions of probation [or] to satisfy the court, that's good enough as far as we're concerned," Walsh said. "We just want them in the door and to be in a safe, structured place where they can get the help they need."

People going into treatment from jail often have one advantage: they've likely already gone through withdrawal, which for opioids can be excruciating. But they're also facing enormous pressure, Walsh said. They've lost their support networks, have limited job prospects and need to cooperate with court-ordered treatment or face legal sanctions.

"As a part of those conditions, they may have years of prison stay that's hanging over their head," Walsh said. "They have a ton that's on the line."

Many treatment program patients will show up with all their possessions stuffed into a couple of garbage bags. Although treatment is expensive, about 90 percent of the program's patients qualify for some form of public assistance, Walsh said.  

The relationship between counties and treatment programs has improved over the years. But there's still no universal system for the 87 counties in the state to put inmates in touch with treatment options.

"It's hit-or-miss depending on what county, what jail that you're working at," Walsh said.

Using the past to find the future

Gena Evans sits for a portrait.
Minnesota Adult and Teen Challenge outreach director Gina Evans sits for a portrait inside of her south Minneapolis office on Friday, August 10, 2018.
Evan Frost | MPR News

An inmate enrolling in treatment from a county jail in Minnesota may run into Gina Evans, who heads up community outreach for Teen Challenge. Inmates voluntarily sign up to learn about treatment options from her team at jails across the state.

Evans said inmates come to the meetings for all sorts of reasons, maybe they know someone from another part of the jail will be there, or maybe they've heard through the jail's grapevine about those who've done well in the program. In 10 years of doing this work, she's only had to kick out one person who was being disruptive. The goal, Evans says, is to figure out what services each specific inmate needs and then work with them to achieve that.

It's also another opportunity for staff to share their own success stories. Most of Evans' team is in recovery and has come out of the criminal justice system. Evans herself has had 13 felony convictions, was incarcerated in the Minnesota Corrections facility in Shakopee three times and lost custody of her children. She entered recovery in the early 2000s, and just two years ago she received an official pardon.

"They're no different than me," Evans says of inmates. "The difference was when somebody presented treatment as an option to me in a prison cell that I took it, and did the things that those people told me were important, and now 15 years later, I'm using my past to be able to help people find their future."

With all the time she's spent in jail, foster care and prison, Evans tells inmates her year in treatment was the "hardest time" she's ever done.

"I really had to figure out what's wrong with me, that I don't feel like I deserve more," Evans said. "That emotional work that had to take place — prison time would have been easier."

By sharing their own stories, from meeting rooms to the rides from jail with Tony Fondie, Evans said they aim to empower people to understand that they can find their way out of a situation where they feel victimized by poverty and the criminal justice system.

"We aren't victims," Evans said, "and seeing that light bulb go off for people when they really realize, 'I'm responsible for being here, and that means that I can be responsible for getting myself out of here' — that's when change starts to happen."

The challenge of opioids

The opioid epidemic has changed how treatment programs like Teen Challenge work.

Evans said she realized a few years back that inmates needed some sort of safe transport from jail to treatment. Getting out of jail can be one of the most dangerous times for opioid users.

"What we're seeing happening is that people with opioid addiction and heroin addiction get out, get clean and their tolerance drops," Evans said. "That's where we see all these overdoses, people getting out of jail, getting out of treatment and getting out of detox, and then going out and dying."

Even when patients do complete a treatment program, it's not unusual with opioids that they'll relapse, in Teen Challenge the average is six treatment episodes. Evans said the treatment industry has started to move towards understanding that addiction and drug dependency can be a disorder.

"Looking at it as a disorder, instead of an incident, really helps people understand that it is a medical condition, and that we need to treat it the same as we do other medical conditions," Evans said.   

Teen Challenge is a faith-based organization with both short- and long-term treatment programs. There was a time that they competed with other programs for clients, Evans said, but the opioid epidemic has made it all the more important to refer inmates to the programs that will serve them best.

"You work with a client in jail, and then they leave our program and go to another program and then you see them on the news," Evans said. "And I'm tired of funerals. I am tired of funerals."