Maine Jail's Monthly Shot Program Slashes Overdose Deaths

When Franklin County jail in Maine switched from daily pills to monthly injections for opioid addiction treatment last year, something remarkable happened. Violence dropped inside the facility, and people released from custody had a real fighting chance at recovery.

The monthly shots work differently than pills. The medication dissolves slowly under the skin and stays in someone's system for 30 days, protecting them from overdose during those critical first weeks after release when risk runs highest.

The results speak louder than any study. Somerset County launched a similar program years earlier and tracked the outcomes closely. People leaving their jail were three times more likely to stay in treatment compared to those from a facility offering only daily pills.

Even more striking: Somerset County recorded zero overdose deaths in the program's first year. The comparison jail, still using daily medication, saw four people die.

Major Ryan Close, who oversees operations for Franklin County Sheriff's Office, noticed changes beyond the statistics. The daily pills created problems inside the jail, with prisoners sometimes coerced into smuggling or misusing them. Since switching to monthly injections, violence decreased and operations became simpler.

The Ripple Effect

The medication is just one piece of a larger transformation. LeeAnna Lavoie, a public health consultant with MaineHealth, explained the program also educates both prisoners and staff about addiction while offering concrete re-entry support.

Alison Prior serves as the jail's re-entry coordinator, acting like an in-house case manager. She helps people prepare for release by connecting them with providers who can continue their monthly shots, arranging transfers to recovery facilities, and offering whatever support helps them succeed outside.

Dr. Alane O'Connor, who directs addiction medicine at both Somerset and Franklin county jails, sees the impact up close. She hears from people who credit the program with saving their lives and from families who got their loved ones back.

The biggest barrier to expansion is cost. Each shot runs about $1,500, and Franklin and Somerset remain the only two Maine jails offering this treatment. Other facilities want to follow their lead but struggle to find funding.

For O'Connor, the financial challenges fade when she sits with someone in jail who tells her the program saved their life, or when families return to share their gratitude.