Q&A: Director talks program, success rates

Editor’s note: This is one in a continuing series of interviews with local officials. Kris Paulus is the Medication Assisted Treatment program director at the Roosevelt County Detention Center.

Q: Briefly explain what the MAT program is and what is its overall goal.

A: There are three FDA approved medications for opioid use disorder, which are methadone, buprenorphine, and naltrexone. RCDC offers buprenorphine and naltrexone to patients who are appropriate candidates.

Buprenorphine is a partial agonist, meaning it does give a bit of the opioid effect but has a “ceiling effect” wherein there is a point where more medication does not result in more physical effect. It is used to reduce cravings and withdrawal symptoms.

Naltrexone is an antagonist, meaning it works in the brain to block and prevent opiate effects. RCDC also utilizes naltrexone for the treatment of alcohol use disorder as it blocks the effects and feelings of alcohol and reduces cravings. 

The goal of the program is to strengthen communication and collaboration between RCDC personnel and community partners to support individuals throughout their incarceration, from booking to release, to sustain recovery, reduce recidivism and improve public safety. 

I hope that people will begin to understand that recovery is not a linear process with defined “start and finish lines” but is a lifelong journey. People deserve the chance to do better without continually having their past mistakes reflected back to them.

Q: When did the MAT program begin? How did it come about and who funds the program?

A: The Roosevelt County manager was approached by staff from the New Mexico Behavioral Health Services Division as the county met geographic markers they were looking for to pilot a program of this sort to address the opioid epidemic. 

Roosevelt County Manager Amber Hamilton worked with the previous detention administrator to develop the initial infrastructure for the program, after which I was brought on to develop the day-to-day operations. 

The MAT program, which officially launched in the fall of 2021, was initially funded by two grants: the Federal State Opioid Response and the State Reach, Intervene, Support, Engage. Currently the program is solely funded by the RISE grant through the Behavioral Health Services Division.

Q: What does the MAT program have to offer for detainees?

A: The MAT program is a holistic approach to recovery, that provides cognitive behavioral substance abuse and mental health education through individual and group counseling, individualized treatment plans, life skills, mindfulness training, exercise, yoga, art, recovery groups, as well as discharge planning and peer support services.

Detainees are also able to participate in GED and parenting classes should they benefit from these. 

Upon release, participants are able to continue utilizing counseling and peer support services to help with the transition back into the community.

MAT medications are utilized when appropriate, however it is important to note that as there are no FDA approved medications for stimulant use disorder a large portion of the participants are not on a MAT medication. 

To date there have been 41 participants prescribed buprenorphine within the facility and 13 participants prescribed naltrexone. Of those utilizing naltrexone, five have received the injectable medication prior to release, which is long lasting and provides coverage for a month.

Q: What is the rate of recidivism for those that participate in the MAT program?

A: Since the program’s inception there have been 66 unduplicated males and 35 unduplicated females in the program. Of these, 37 males and 23 females were released to the community with 32% of the males and 22% of the females being rebooked into RCDC with a new criminal charge.

Q: Any specific success stories you’d like to share?

A: Success can be measured in many ways. It’s a success when we have a participant with anger management and impulse control issues who learns and uses the skills necessary to change these types of negative behaviors. 

It’s a success when we have a participant who learns to actually feel and talk about emotions without self-medicating.

We’ve had one participant return to the community in 2022 to a home where the parents and spouse all used drugs. 

The participant has been able to stay drug free, obtain and keep the same job for the past two years, obtain independent housing, leave the relationship and obtain custody of the couple’s child.

The participant is active in local recovery groups and is developing a plan to become a certified peer support worker and pursue a degree in counseling or social work.

Q: Are there any goals you’d like to reach in the future?

A: So many. For starters, I would love to expand our re-entry services by connecting with community partners to increase resources for housing and employment. In order for people to keep moving forward and sustain recovery, they have to first be able to meet basic needs, such as food, clothing, and shelter. Without resources for a job or place to stay people experience feelings of hopelessness and often return to negative situations. 

I would also like to build out our education/trades programming. MAT participants are able to obtain specific skills, to include gardening, raising chickens, and obtaining their New Mexico Food Handler’s certificate, as a way to increase their knowledge base and employment opportunities when released.

Q: Any changes you’d like to make?

A: Our MAT program is continually changing and evolving. As we started from scratch, we’ve had the freedom to think outside the box, implementing innovative ways of doing things, keeping what works and changing what doesn’t. 

We recently began a chicken program, where participants are responsible for raising and caring for chickens, to include feeding, watering, coop cleaning, and socialization. 

We received them as pullets when they were two hours old and detainees created their own schedule to ensure that the needed care is provided both morning and night. They will continue this and expand into egg gathering when the hens start to lay. 

This project allows participants to learn empathy in caring for something other than themselves, as well as responsibility and hands-on skills that can be used when returning to the community.

— Compiled by Landry Sena, the Staff of the News