Breaking the Cycle
Photo by Jared Castaldi
Jordan Hyatt, JD, PhD
assistant professor of criminology and justice studies
It is one of our nation’s most pressing and persistent public health crises. It is responsible for more than 25,000 deaths each year nationwide, and as many as 3,500 annually in Pennsylvania alone. It reaches from the inner cities to wealthy suburbs and out into the countryside, and its recent growth has been described by officials at the Centers for Disease Control as “unprecedented.”
The “it” is opioid addiction, and Jordan Hyatt, JD, PhD, is working to find a much-needed solution to this epidemic in perhaps the most challenging context of all: our nation’s jails and prisons.
Hyatt, an assistant professor of criminology and justice studies at Drexel, has established himself as one of the region’s leading experts in what he calls “the back end of the criminal justice system.” With research focused in areas such as probation and parole, sentencing and community corrections, Hyatt aims both to understand what happens to individuals after they leave the system and to find new and better ways to make sure they don’t fall back into old habits — and end up right back behind bars.
“My research is really all about program evaluation — what works, what doesn’t work and why,” explains Hyatt. “I aim to generate the most rigorous evidence so that agency heads and decision makers can make the most informed decisions possible regarding all of these issues.”
While there are any number of issues that can draw former offenders back into a life of crime, addiction is one of the most persistent — and the extent of the problem among the nation’s prison population is staggering.
According to the Pew Charitable Trusts, approximately 65 percent of the nation’s 2.3 million inmates are addicted to either drugs or alcohol (compared to just 9 percent of the general population). Unfortunately, Hyatt says, most of the programs aimed at curbing these numbers — and the high recidivism rates caused by addiction — have fallen far short.
But now, in ongoing research conducted in partnership with the Pennsylvania Department of Corrections, Hyatt is investigating the efficacy of an anti-addiction drug called Vivitrol in curbing addiction — and, by extension, helping ex-inmates live fuller, more productive lives. The research is notable not only because of its great promise, but also because it represents a radical shift in how corrections officials are working to solve this difficult problem.
“If someone comes into the emergency room or has an interaction with a police officer or is identified in school, we need to plug them into the treatment infrastructure,” says John Wetzel, secretary of the Pennsylvania Department of Corrections. “I think this is so different for us as a country, and it signals a difference in philosophy to focus on identifying the root cause of the crime to put someone on the path to be less likely to commit a crime.”
Unlike two other common opioid-treatment medications — methadone and buprenorphine — Vivitrol is not a narcotic. Rather, it is in a class of drugs called “antagonists,” which work by essentially blocking the brain and body from attaining a drug-induced “high.” Administered by injection, the drug can block drug-induced highs for a month at a time.
“Methadone has been the common treatment for opioid addiction, but it’s not an ideal solution at all,” Hyatt says. “First, it requires individuals to take a pill every day. And more importantly, it’s not a fit for correctional facilities because, as a narcotic, it can be abused as well. With Vivitrol, the participating inmates — all of whom are soon to be released — get a shot once a month and for the rest of the month, they are immune to what they consider the ‘positive’ experience of using heroin or other drugs.”
Numerous trials have already shown the drug to be effective in a variety of contexts, but, Hyatt explains, his study goes beyond Vivitrol alone. As well as voluntarily receiving the drug treatment, inmates in the program also receive support and counseling to help steer them in the right direction. The goal is to provide a more thorough, holistic experience, Hyatt says.
Though the results of the study aren’t yet final, Hyatt says early indications are that his work will generate a strongly positive outcome. “We would certainly expect to see a reduction in positive drug tests once they are back in the community, as well as an associated reduction in recidivism … simply because they will be less likely to be under the influence.”
Of course, Hyatt does not believe this particular line of treatment, even if implemented across the justice system, will be the silver bullet to solving the imposing problem of opioid addiction; it’s simply too massive of a problem to be solved in any single way.
But in the world of corrections, at least, it would represent a potential key win — and an important change in philosophy — in a much broader battle against the perils of addiction.
“This is a growing crisis that has become a very significant issue in the public health discourse,” he says. “And it goes without saying that this is one of our most at-risk populations. These individuals enter the system, and for those who have an addiction history, it is very common for them to return to their old ways when they get out — and then they cycle right back in. What we’re trying to do with our research is find a way to help these individuals break that cycle.”