Wellborn: Expand Treatment, Not Jail, for Opioid Use

There are 121,000 Mississippians currently in need of treatment for substance use disorders, according to Dr. Mary Currier, the State Medical Officer. But in all of Mississippi, there are a total of 501 beds, certified by the Department of Mental Health, to treat such disorders. Mississippi, like the rest of the nation, is in the midst of an opioid epidemic. Large numbers of our citizens have become addicted to legal drugs, prescribed to them by medical professionals.
Our response has been to answer this epidemic with abrupt prescription crack-downs, thereby encouraging a migration to illegal drugs as a replacement. The result has been a doubling of fatal overdoses in Mississippi, which plainly reveals the ineffectiveness of our current strategy. Treating addiction as a criminal matter is wrong and does nothing to solve the underlying problems faced by these Mississippians.
For us, this epidemic is still in its early stages, but the coming crisis is so clear that major public figures, such as Marshall Fisher, head of Mississippi’s Department of Public Safety, and Dr. Currier, have spoken out on the limitations of law enforcement and the state’s health system to either stop, mitigate, or manage the damage that is being done to our communities and our broader society.
Not only do we have far too few beds available for treatment, there is no tracking or coordinating technology to effectively match patients to beds. There are scarce resources to manage patients awaiting beds, and predictably some patients who desire treatment become more firmly addicted after waiting overlong for those beds.
Historically, Mississippi has relied upon law enforcement and the courts to deal with substance use issues. Unfortunately, neither were designed as regulatory or preemptive agencies. Still, 20 percent of Mississippi’s inmates, 38 percent of our probationers, and 48 percent of our parolees are there on drug charges. At the cost of $18,615 per year (plus medical expenses) to house a single prisoner at Parchman Penitentiary, we are using a vast amount of resources on an ill-fitting solution. Incarceration does little to rehabilitate, isolates individuals from family and other positive allies and resources, and ultimately creates the need for the taxpayers to expend more resources after imprisonment on welfare and recovery systems. The criminal justice system is not the right tool for a public health crisis.
We have 121,000 Mississippians currently outside the prison system that struggle with substance use disorders. Many of these have underlying mental health issues. Yet statewide, we have the ability to treat only 501 at a time.
Mississippians must recognize the coming threats and reexamine our ultimate objectives in order to develop better, cheaper, and more effective responses to substance use.
Clearly, we must increase capacity to effectively treat substance use disorders. The Department of Health has unequivocally stated the need for more beds and better technology to coordinate the use of those beds for maximum effect. We should develop these capacities now, before our health systems are completely overwhelmed.
We must also find new tools to prevent substance use disorder and help people who are struggling with it. At every opportunity, we should divert them away from the criminal justice system.
We should also develop support and counseling networks at the community level. Imagine churches and community organizations throughout the state offering their facilities and a few volunteers to host a weekly telehealth counseling session for those in their local community. Matching the substance use and mental health resources available in Jackson’s premier medical community with local social networks would enable coverage to every corner of the state at very low cost, and would alleviate many problems related to our backlog of treatment needs.
It is time to treat substance use and mental illness as health issues. The criminal justice system is the wrong tool for the task.

Bradley Wellborn, B.A. & J.D. from Ole Miss, is a former Navy officer, former Special Assistant U.S. Attorney, Eagle Scout, and maintains a general practice law firm in Jackson.
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