In an Upstate Jail, Incarcerated People Struggle to Access Promised Addiction Treatment
A sign protesting conditions in Broome County Jail | Justice and Unity for the Southern Tier

In an Upstate Jail, Incarcerated People Struggle to Access Promised Addiction Treatment

In 2019, Broome County promised an addiction treatment program in its jail. Two years later, the program is a “farce,” one advocate said.

This story was published in partnership with Filter, a nonprofit news site covering drug use, drug policy and human rights. Sign up for their newsletter here.

In 2019, the local jail in Broome County, home of Binghamton, was one of several county jails in upstate New York to begin offering medication for opioid use disorder. Attention to the role that treatment in jails and prisons could play in reducing fatal overdoses after release had been growing across the country, and the decision seemed a promising sign that New York could become a national leader on the issue.

But nearly two years later, people currently and recently incarcerated in the Broome County jail say that access has been extremely limited. Drug policy advocates say the inconsistent access to medication demonstrates the need for a statewide mandate to provide incarcerated people with opioid addiction treatment, rather than a patchwork system dependent on the attitudes of local sheriffs and jail administrators.

In February 2021, John*, a 30-year-old resident of Broome County, was reincarcerated in the county jail for violating the conditions of his parole. For the previous four months, he had been taking Suboxone, a medication that helps minimize withdrawal symptoms for people with opioid use disorder.

“Suboxone made it so I could function and I wasn’t anxious and I didn’t want to use other drugs,” John recalled.

But upon being sent to Broome County jail, he said, he lost his access to the medication. He entered opioid withdrawal. He also experienced symptoms of psychosis, which he attributed to loss of access to medication keeping his depression and schizophrenia in check. He was taken to the medical unit, where he experienced a psychotic break, he said, and lost consciousness.

When he woke up, he said, he found himself strapped into a restraint chair, where he was forced to remain for 12 hours while experiencing opioid withdrawal. “They didn’t give me my meds. They didn’t give me nothing,” John said. “It felt horrible.”

About a week later, he said, the jail’s medical staff began giving John medication for his depression and schizophrenia. But they told him that he would not be given Suboxone because his urine had tested positive for marijuana, he said, despite the fact that marijuana use does not prevent successful Suboxone treatment. 

John remains incarcerated and unable to access the treatment. “They said no and that’s the rules,” he said. “I am a lot more depressed. I’m coping with it. I have no choice.”

Alexis Pleus, executive director of Truth Pharm, a Broome County-based organization that advocates for the welfare of people who use drugs, said she routinely hears stories like John’s.

“We’ve had so many people contact us and say, ‘My son was on Suboxone and the jail stopped it,’” Pleus said. “I haven’t had anyone tell me they had a good process of getting their needs there. It’s a farce. Or it’s extremely limited.”

John said that while he has heard of other incarcerated people in Broome County’s jail getting Suboxone, most get refused.

The jail claims that its medication for opioid use disorder (MOUD, sometimes known as medication assisted treatment, or MAT) program serves its intended population. “We have an active [MOUD] program in conjunction with the folks at UHS hospital, and we provide medically assisted treatment to the individuals who are indicated in need at the time of admission to the correctional facility,” said Broome County Major Mark Smolinsky, the administrator of the jail.

Jail administration did not respond to inquiries regarding the number of people the jail has approved for MOUD. Alan Wilmarth, the administrative director of behavioral health at UHS hospitals and the administrator of the MOUD program at Broome County’s jail, declined to be interviewed for this article.

Asked about reports of people who say the jail denied them Suboxone or other forms of MOUD, Smolinsky said that use of other drugs could be a reason to deny someone treatment. “Sometimes you could have a case where somebody is also taking maybe a number of other street drugs, whether it’s methamphetamines or K2 or some of the synthetic stuff like that, where it’s then unsafe to continue the Suboxone,” he said.

But one specialist in addiction medicine said that this policy does not accord with best practices for treating opioid use disorder.

“There isn’t really a circumstance or a street drug that is contraindicated with buprenorphine,” said Dr. Justine Waldman, an emergency medicine physician in Ithaca who has prescribed buprenorphine, the generic form of Suboxone, to hundreds of patients. “Every patient who has opioid use disorder should be on a form of medication for opioid use disorder.”

In September 2020, Isaac*, a 25-year-old resident of Broome County, was sentenced to six months in the jail after being convicted of multiple counts of illegally possessing syringes, a misdemeanor offense. Prior to his imprisonment, he had been regularly injecting heroin and buying Suboxone off the street when heroin was unavailable.

As he was being admitted to the jail, Isaac warned staff that he would experience withdrawal. “I told them, ‘I’m going to be sick,’” he said. “They should have put me in medical.” He was not offered medical care and was instead placed in a quarantine cell due to COVID-19 precautions, he said.

Shortly thereafter, Isaac entered opioid withdrawal. “You just have to cry,” he said, describing the experience. “You can be how tough you want; it doesn’t matter. You will cry like a little baby because it hurts.”

Some corrections officers knew that he was going through withdrawal and would periodically check on him, but he was never given medical attention, he said, and was never told that MOUD was available. “I didn’t know that they help you with being sick in jail,” he said. 

In the six months that he was in jail, Isaac heard of just one person incarcerated there being approved for Suboxone treatment, he said.

Isaac was released from jail in mid-March. But he has been incarcerated several times, and his sister worries that without reliable access to medication, if he is sent back to the jail again, he could become its next fatality. “If he has to go back after doing drugs again, it gets to the point where you don’t expect him to come out,” she said. “I didn’t expect him to come out this time.”

Broome County’s jail has previously received attention for its poor health conditions. As many as 11 people have died there in the past decade, and last April, the New York Post reported that incarcerated people were being forced to clean the medical unit where COVID-19 patients were being treated without being provided with proper PPE.

Many other jails in New York, and the large majority of its prisons, have no MOUD program at all. But some of the programs that do exist in other jails—including in Albany County, Monroe County, and Onondaga County—have been highly effective, medical professionals and formerly incarcerated people said.

In the Albany County Jail, “as soon as a person identifies that they have an opioid dependence, they are hooked into services,” said Stephanie Lao, the executive director of Catholic Charities AIDS services, which worked with Albany County Sheriff Craig Apple to implement the MOUD program. Since the program began in 2019, Lao has not heard of any cases where people who requested MOUD have not received it, she said.

Both recidivism and fatal overdoses among people released from the Albany County Jail have significantly decreased since the program was instituted, data show. The recidivism rate of participants in the MOUD program stood at 13 percent in November 2019, far lower than the 40 percent overall rate. Lao said that she is not aware of any fatal overdoses occurring among program participants, even as fatal overdoses have risen in Albany overall.

In Monroe County, home of Rochester, Tee-Jay St. John was able to access MOUD while incarcerated in 2019. “I always had this notion that being in jail you would be treated like shit, but honestly, it was a beautiful experience,” St. John said about the program. “The sheriffs were trained properly, knew what we were going through, and they would show compassion.” 

No severe withdrawals have occurred in the jail since the MOUD program was instituted in 2019, said Robert Lee, who works closely with incarcerated and recently incarcerated people in the county jail and at a Rochester halfway house.

These programs have succeeded because of the county sheriffs’ dedication to them, both Lao and Lee said. In Albany, Sheriff Apple “recognized the value [of MOUD] specifically around reducing overdoses,” Lao said. “When he made that decision, he told his staff to just make it happen.”

In Broome County, by contrast, Pleus said, Sheriff David Harder has not been committed to the success of the MOUD program. “He doesn’t provide any leadership or make sure that things work well,” she said. “He takes a real hands-off approach to his own jail.” Harder’s office declined to make him available for comment.

State funds to expand incarcerated people’s access to MOUD could soon be made available. A measure in the Senate’s budget proposal, also supported by Assembly Speaker Carl Heastie, would allot millions of dollars per year in grants to counties to expand MOUD in jails. The Senate’s budget proposal also includes passage of a currently-pending bill to mandate the provision of MOUD in all jails and prisons statewide. Whether these measures become law will depend on the outcome of negotiations between the legislature and the governor, as the April 1 deadline to enact New York’s 2021-2022 budget approaches. 

Advocates say that counties like Broome demonstrate the need for such a comprehensive statewide MOUD mandate, which would reduce the discretion of individual counties and sheriffs and guarantee treatment to all incarcerated people.

A state law mandating MOUD in all New York jails and prisons would create a clear standard under which incarcerated people would be entitled to MOUD, enabling them to sue jails and prisons if needed access is denied, said Jasmine Budnella, drug policy coordinator for grassroots lobbying organization VOCAL-NY.

“When you don’t have a law that is regulating county jails and sheriffs, then we are going to see sheriffs continue to use their power against vulnerable people,” Budnella said.  

*Names have been changed to respect sources’ privacy.

Albany Just Blew it on Climate, Again
Albany Just Blew it on Climate, Again
Only big, strong, mean grassroots campaigns can turn this around ...

By

Wage Theft Got Worse During Covid. A Stalled Bill Could Give Workers Leverage To Fight Back
Wage Theft Got Worse During Covid. A Stalled Bill Could Give Workers Leverage To Fight Back
Cuomo pledged to deal with rampant wage theft this year, then failed to deliver. Now, a bill to recover stolen wages is unlikely to pass the legislature....

By

Inside New York’s Grueling Parole Application Process
Inside New York’s Grueling Parole Application Process
As legislators consider reforms to New York’s parole system, former prison officials and incarcerated people describe the barriers to parole release....

By

Progressives Mobilize to Block Cuomo’s Tough-on-Crime Pick For Highest NY Court
Progressives Mobilize to Block Cuomo’s Tough-on-Crime Pick For Highest NY Court
Madeline Singas, a close Cuomo ally, has been a prominent opponent of criminal justice reforms and has taken a punitive approach as Nassau County DA, defenders say....

By

How a Tenant Revolt Sank NYCHA’s Biggest Overhaul Plan in Years
How a Tenant Revolt Sank NYCHA’s Biggest Overhaul Plan in Years
With a week left in the legislative session, New York lawmakers shelved a plan that aimed to revamp 25,000 NYCHA apartments....

By

Anticipating Pushback From Finance, Enviros Move to Regulate Energy-Intensive Crypto Mining
Anticipating Pushback From Finance, Enviros Move to Regulate Energy-Intensive Crypto Mining
Founded by a major Cuomo donor, Renaissance Technologies is set to become a stakeholder in upstate mining operation that touched off backlash against Bitcoin....

By

How New York State Let Covid-19 Run Rampant in Prisons
How New York State Let Covid-19 Run Rampant in Prisons
First, the state failed to protect people in prison from the virus. Then, it obscured the full scope of the crisis, advocates charge....

By

Inside the chemical lobby’s unusual campaign to protect the fire retardant business
Inside the chemical lobby’s unusual campaign to protect the fire retardant business
Chemical industry lobbyists are aggressively fighting a bill that would ban the use of toxic flame retardants—including by placing stories in local news outlets with quotes from a tenant organizer w...

By

A Manhattan DA Candidate Touts Her Leadership of a Conviction Review Unit. Why Did It Exonerate So Few People?
A Manhattan DA Candidate Touts Her Leadership of a Conviction Review Unit. Why Did It Exonerate So Few People?
Under Tali Farhadian Weinstein’s leadership, Brooklyn’s unit exonerated just three people — a far lower rate than in previous years....

By

Could Public Ownership Save the New York Power System?
Could Public Ownership Save the New York Power System?
New York’s profit-driven power system leads to higher costs, more blackouts, and more fossil fuels, activists say....

By

The Domestic Violence Survivors Justice Act Gets A Slow Start
The Domestic Violence Survivors Justice Act Gets A Slow Start
Two years after New York enacted a high-profile law to reduce prison sentences for domestic violence survivors, few survivors have seen much benefit....

By and

Two years after passing a landmark climate law, New York has no plan to fund it
Two years after passing a landmark climate law, New York has no plan to fund it
Governor Cuomo just approved the largest budget in New York history — and it has virtually no new funding to help meet the goals in New York's landmark climate law....

By

Why Is New York Still Taxing Unemployment Benefits?
Why Is New York Still Taxing Unemployment Benefits?
Unemployed New Yorkers are receiving surprise tax bills. Republican legislators joined with progressive Democrats to move to waive taxes on benefits, following the lead of most other states and the fe...

By

Gas plant in Newburgh tests limits of NY’s landmark climate law
Gas plant in Newburgh tests limits of NY’s landmark climate law
Can New York meet its emissions goals if it green-lights more fossil fuel infrastructure? A proposal to rebuild a fracked-gas plant will set the precedent....

By

Health Care Costs for Retired City Workers Could Dramatically Increase Under City Plan
Health Care Costs for Retired City Workers Could Dramatically Increase Under City Plan
A quarter million retired city workers could be left with bigger health insurance bills and fewer doctor choices under a city plan to change their health insurance....

By

A New Threat to New York’s Clean Energy Goals: Bitcoin Mining
A New Threat to New York’s Clean Energy Goals: Bitcoin Mining
A Finger Lakes power plant plans to ramp up energy-intensive Bitcoin mining. If the state allows it to proceed, environmentalists warn dozens of fossil-fueled plants could follow....

By

Thousands of New Yorkers are in Prison for Life. These D.A. Candidates Want to Change That
Thousands of New Yorkers are in Prison for Life. These D.A. Candidates Want to Change That
Manhattan D.A. candidates vow to reduce lengthy sentences—but sharp differences between their approaches remain...

By

What Made It Into The Budget – And What Was Left Out
What Made It Into The Budget – And What Was Left Out
The major provisions of New York's 2021 budget....

By , and

Homelessness Priorities Won’t Make the State Budget, Lawmakers and Advocates Say
Homelessness Priorities Won’t Make the State Budget, Lawmakers and Advocates Say
“A year from now, this money will still be in the hands of Governor Cuomo, unused - and that’s exactly what he wants.”...

By

“A byzantine and high-bar system”: Governor pushes to saddle undocumented workers fund with documentation requirements
“A byzantine and high-bar system”: Governor pushes to saddle undocumented workers fund with documentation requirements
State lawmakers and workers' rights advocates warned that burdensome proof-of-employment requirements may mean the funds go unspent....

By

Will New York’s Rent Relief Program Address The Problems that Hobbled The Last One?
Will New York’s Rent Relief Program Address The Problems that Hobbled The Last One?
Governor Andrew Cuomo is pushing to impose stringent requirements, according to lawmakers and tenant advocates, that could delay and decrease aid....

By

Where are the Safe Injection Facilities Cuomo Promised for New York?
Where are the Safe Injection Facilities Cuomo Promised for New York?
He committed three years ago to supporting safe injection sites for drug users — then reversed course, activists say. Now, they see a new chance to pressure the embattled governor....

By

Legislature Seeks to End “Arbitrary Limit” on Medicaid Spending
Legislature Seeks to End “Arbitrary Limit” on Medicaid Spending
A 2011 rule prevents New York from adequately funding Medicaid, advocates say. This year’s budget could see it repealed. ...

By

Will Rental Vouchers to Prevent Homelessness Make the State Budget?
Will Rental Vouchers to Prevent Homelessness Make the State Budget?
The legislature is pushing for a statewide rental assistance program that advocates say would be one the largest efforts to combat homelessness in recent memory....

By

New York’s biggest climate problem—and opportunity
New York’s biggest climate problem—and opportunity
Buildings may be New York’s top source of emissions. The state should follow the city’s lead in cleaning them up....

By

In an Upstate Jail, Incarcerated People Struggle to Access Promised Addiction Treatment
In an Upstate Jail, Incarcerated People Struggle to Access Promised Addiction Treatment
In 2019, Broome County promised an addiction treatment program in its jail. Two years later, the program is a “farce,” one advocate said. ...

By

Records Reveal New York’s Growing Mountain of Water Debt
Records Reveal New York’s Growing Mountain of Water Debt
Advocates are pushing the legislature to extend and strengthen a moratorium on water shutoffs set to expire at the end of the month....

By

Legislative Leadership to Propose $7 Billion in New Taxes, Sources Say
Legislative Leadership to Propose $7 Billion in New Taxes, Sources Say
Tax-the-rich advocates critiqued the figure as too low, and also said the Assembly is significantly behind the Senate on key progressive spending priorities....

By

Queens Public Defenders Win Unionization Vote
Queens Public Defenders Win Unionization Vote
After months of conflict involving alleged intimidation and potentially illegal firings, workers at Queens Defenders voted overwhelmingly to unionize....

By

“It Damages Democracy:” Watchdogs, Reporters, Slam “Non-Functional” Board of Elections Campaign Finance Website
“It Damages Democracy:” Watchdogs, Reporters, Slam “Non-Functional” Board of Elections Campaign Finance Website
Flaws in an updated website make it extremely difficult to track who is funding campaigns, journalists and watchdogs say, but the BOE insists that “the site is fully functioning.” ...

By

Will New York allow incarcerated people to access treatment for drug addiction?
Will New York allow incarcerated people to access treatment for drug addiction?
"People in prison deserve healthcare, and this is healthcare.” Legislators push to offer treatment for drug addiction in jails and prisons...

By

“Mired in Incrementalism”: Climate Action Council Proceedings Alarm Climate Advocates
“Mired in Incrementalism”: Climate Action Council Proceedings Alarm Climate Advocates
Under New York's climate law, the Climate Action Council is tasked with devising a plan to zero out emissions. Environmentalists on the Council say it's not on track....

By

In Manhattan D.A. Race, Momentum Builds to Decriminalize Sex Work
In Manhattan D.A. Race, Momentum Builds to Decriminalize Sex Work
In a striking sign of activists' success, most candidates running in the June election for DA say they would not prosecute cases involving consensual sex work....

By

“We Need to Hold Him Accountable”: After Sexual Harassment Allegations, Legislators Search for Ways to Respond
“We Need to Hold Him Accountable”: After Sexual Harassment Allegations, Legislators Search for Ways to Respond
With the state ethics commission widely seen as controlled by the governor, legislators are looking for other ways to investigate the allegations....

By

Top state lawmakers oppose Cuomo’s push to override NYC’s landmark climate law
Top state lawmakers oppose Cuomo’s push to override NYC’s landmark climate law
A new analysis finds that the governor’s proposal would “completely undermine” New York City’s climate law, setting the stage for a clash with the newly emboldened legislature....

By

As State Support Dwindles, New York’s Overdose Crisis is Only Getting Worse
As State Support Dwindles, New York’s Overdose Crisis is Only Getting Worse
State withholds have left harm reduction providers undersupplied, and informal overdose prevention networks are struggling to fill the gap....

By

Queens Defenders Fires Two Pro-Union Employees
Queens Defenders Fires Two Pro-Union Employees
Amid an ongoing union election at the Queens indigent defense law firm, two outspoken union supporters were fired without warning....

By

“It’s a life or death situation out here”: a brutal winter for unsheltered New Yorkers
“It’s a life or death situation out here”: a brutal winter for unsheltered New Yorkers
“We sleep together like chickens”: Street homeless New Yorkers describe the struggle to endure the pandemic-era winter....

By

Will Manhattan’s Next D.A. Break Ranks With Tough-on-Crime Colleagues?
Will Manhattan’s Next D.A. Break Ranks With Tough-on-Crime Colleagues?
Three candidates in the June election say they would not join the association of state DAs, which has fought measures such as bail reform....

By

“What am I to do?” An oral history of mothering children in online school
“What am I to do?” An oral history of mothering children in online school
“I’m the security guard, a mother, a father, a teacher, I’m everything." Parents and children reflect on a year of remote learning and its impact on their finances, mental health, and family....

By

Subscribe to our Newsletter!

Be the first to hear about our stories - and get a nugget of NY history each week!