Yusuf Bibb says he knows every heroin addict in Louisville. Many of them he would see as they cycled in and out of the Louisville Metro Department of Corrections’ detox program.
“The turnover…they’d be bringing them in and out,” Bibb says. “I almost seen every heroin addict in this city.”
Bibb, 28, has been to jail three times in the past seven years for crimes related to selling drugs. The last time, he participated in a program called Enough is Enough, a local initiative designed to teach inmates life skills as they help care for other inmates who are going through drug detox — the process by which addicts get clean and rid their bodies of drugs. Approximately 90 inmates at a time participate in the three-month program.
Common opiate withdrawal symptoms include body aches, increased sensitivity to pain and other flu-like symptoms. Experts say the length of the symptoms varies depending on the type of drug and length of abuse.
While he worked with Enough is Enough, Bibb says he cleaned up other inmates’ vomit, made sure their heads didn’t hit the floor during violent withdrawal seizures and made their beds.
Making an ‘IMPACT’
Louisville is betting that those heroin addicts Bibb knows so well will want help putting a stop to the vicious cycle of addiction and incarceration.
Metro Corrections is in the planning stages of a pilot project called Innovative Metro Project and Addiction Care and Treatment (IMPACT). It will link an estimated 1,000 to 1,500 inmates with immediate substance treatment upon discharge.
Last month, the city won a $50,000 award from the Massachusetts Institute of Technology (MIT) to develop the program. The pilot will be based on a ‘pay-for-success’ model, where investors will give the department money to pay for the treatment and get paid back if the program works.
Louisville Metro has set aside $1 million for the next five years to pay those investors back. They are looking for other investors to help with the cost of treatment. Metro Corrections will get an expert academic to help with the evaluation of the results.
“If the hypothesis is correct, that would be a significant cost savings,” says Quentin Palfrey, executive director at the Abdul Latif Jameel Poverty Action Lab at MIT. “If it turns out the program works and can keep people from returning to jail, instead of paying the larger amount of incarcerating individuals, they’ll pay for the cost of substance treatment.”
Metro Corrections Director Mark Bolton says currently, when people are booked while high on drugs, they are sent to a detox unit to receive medical care. After they’ve completed the detox, they’re sent back to the general population.
Last year, 3,658 people were were released from Metro Corrections while actively detoxing from drugs. As of the end of June of this year, 2,306 people have been released while in active detox. That’s about 400 releases per month. Bolton says the new program will target that population.
“Every single day, we’re releasing people who are opiate addicts and returning them to the community in active detox,” he says.
Last year, 5,055 people detoxed on opiates while in Metro Corrections — almost twice the number in 2012. There were also higher rates of people coming into jail high on alcohol and prescription drugs, like Xanax.
Metro Corrections designates $10 million of its annual budget for medical care, including drug detox. The facility has a Medicaid enroller who helps inmates sign up for coverage following discharge, which could pay for drug treatment once they are released. But the people cycling in and out are not there long enough to go through the application process, let alone recall personal information required for applying.
There’s an incentive for the department to help people get clean. A 2012 study by research group RTI International found if 10 percent of offenders were sent to treatment programs rather than prison, the criminal justice system would save $4.8 billion of what would be spent on incarcerations. And if 40 percent were sent to treatment, cost savings would jump to $12.9 billion.
There’s also hard evidence that shows people who are on drugs when they enter jail have higher rates of returning to jail – leading to higher operating costs. Between 2013 and 2014, Louisville detoxing inmates spent an average of 30 more days in jail than people who weren’t on drugs when they arrived.
‘Just Like All of Us’
Bibb’s own history helped teach him how to care for addicts. When he was a child, Bibb’s mother was addicted to drugs and when he was as young as nine, she would leave him to clean the house, clothe himself and figure out how to get food.
At age 13, after having what he only refers to as an “outburst” at his mother, Bibb was suspended from school. His mother sent him to a known drug dealer from the neighborhood “and she put me in his care to shape me, and to start bringing in revenue through selling drugs.”
Bibb says seeing his own mother struggle with addiction helped him to view other addicts in a different light.
“If I can help an individual pull their self together and be a better parent, I’d be more than willing to do that,” Bibb says. “I would hate to see a child go through the things I went through.”
Bibb now works at New Legacy Reentry Corporation, a nonprofit that helps former felons with housing, job training and life skills. As for his mother, he says she’s still on drugs and they remain estranged.
From time to time, Bibb says he still sees people he knew from his time at Metro Corrections. And he’s skeptical that IMPACT will help them. But he says there needs to be help for addicts — people like his mother — in order to put an end to the cycle of drug addiction.
“There was one guy, we’d see him every other weekend, he would just drop on by,” Bibb says. “And he was an older gentlemen, he just had a problem. I didn’t look down on him, because he still had a spirit and he was still intelligent and he was still a human being that deserved attention and love — just like all of us do.”
Lisa Gillespie is WFPL's Health and Innovation Reporter.