Just before Marcus Lewis tried heroin for the first time, he received a warning from a friend: the drug was highly addictive, and he could get hooked even if he used it just a few times.
“I heard him say it, but I didn’t really get it until it happened to me,” Lewis said on a recent Thursday in New Haven, roughly 33 years after that moment. “Your body depends on it, as it depends on food, air, oxygen.”
Born and raised in Norwalk, Lewis, 53, has spent the last three decades in and out of prison for crimes like possession with intent to sell that he said were tied to his opioid addiction, just as his friend had warned.
“If I wasn’t using, I wouldn’t have been out in the street,” Lewis said. “I was basically selling to either pay bills or support my habit.”
His addiction to opioids is reflective of a much larger crisis, one that has ravaged the entire country. Its effects have been particularly devastating for people who have experienced incarceration.
Nearly three-quarters of people behind bars in the state have a substance use disorder requiring some level of treatment, according to a report from the Connecticut Sentencing Commission, compared to only 17% of the national population overall. For most of the last decade, formerly incarcerated people have accounted for roughly half of the annual overdose deaths in Connecticut.
Now, millions of dollars from several large legal settlements are beginning to flow into the state to help combat the deadly opioid epidemic. Part of that money could go to addressing the opioid crisis’ effect on justice-involved people, the vast majority of whom are Black and Latino.
Experts from Yale University’s Schools of Medicine and Public Health recommended that officials use part of the funding to ensure that people in and transitioning out of the Department of Correction’s custody have access to all three FDA-approved medications for opioid use disorder — methadone, buprenorphine and naltrexone.
And there is overwhelming evidence that the medications work to curb cravings and reduce overdose deaths. One study, for example, found that methadone and buprenorphine reduced the risk of dying from an overdose by 59% and 38%, respectively.
The availability of medication-assisted treatment, or MAT, in prisons has improved dramatically over the last decade. Before 2013, only pregnant women at the state’s designated women’s facility, York Correctional in Niantic, could get treatment of any kind. Currently, 10 of the state’s 13 prisons offer at least one medication. Six offer all three, including York.
But even with the significant increase in the availability of MAT in prisons, not everyone in DOC custody has access to it. Three facilities — Manson, Cheshire and Brooklyn — do not offer any of the medications.
“There is space for expansion; I can say that,” said Sandra Violette, the DOC’s director of addiction services, who believes the agency needs more funding to offer medication in all facilities, an achievement that would put Connecticut in lockstep with Rhode Island, which launched a statewide medication program for opioid use disorder in 2016.
Still, residents who have experienced incarceration and addiction say that focusing solely on expanding treatment won’t fix the problem. A comprehensive solution, they say, must also include repairing the state’s reentry system.
“They got meetings and groups and stuff in jail to try to keep you occupied and try to help you with addiction,” said Lewis, who started taking methadone before his most recent sentence and was able to continue treatment at Osborn Correctional in Somers. “That’s just a Band-Aid. This is where it really counts. It counts out here.”
Before his release from Osborn in February 2023, Lewis said he was told by counselors in the DOC that he would receive assistance during his transition back into the community, like obtaining an ID and housing vouchers. But a year later, he still hasn’t found permanent housing or even managed to get an appointment with the therapist he was seeing before his arrest.
“They keep telling you, ‘We’re going to help you with this; we’re going to help you with that,’” Lewis said. “But if you don’t know no better, you ain’t getting no help.”
Seeking treatment
The expansion of medication-assisted treatment in prisons has given more people who want it the opportunity to begin treatment for their addiction while incarcerated.
Anjolina Stoney, 34, who was born and raised in Waterbury, started taking methadone at York, where she is currently incarcerated. Getting access to treatment, Stoney said, makes her hopeful she will stay sober once she returns home.
“I think it’s an awesome program,” said Stoney, who is currently serving a 2-year prison sentence for drug-related charges. “I feel like when I get out, I have a chance at actual recovery because I don’t have cravings anymore for opiates now that I’m on the methadone.”
Connecticut is one of 15 states that offer comprehensive MAT services in a considerable number of its jails or prisons, according to a June 2023 report. Currently, the DOC offers two of the FDA-approved medications — methadone and an injectable form of naltrexone known as Vivitrol — in 10 of its 13 facilities. In six of the facilities, the agency offers suboxone, a medication containing buprenorphine, and said it is making plans to offer it in another two.
Every morning at York, Stoney said she and everyone else on methadone visits a nurse who dispenses the medication, which comes in a liquid form. She also attends group counseling sessions once a week.
Violette, the DOC’s director of addiction services, said that because Connecticut’s jails and prisons are under the DOC’s supervision, the agency is able to move people around based on their treatment needs. However, there are currently people in custody who want treatment but don’t have access to it.
In December 2016, the Rhode Island Department of Corrections offered an example of what Connecticut hopes to accomplish: It launched the first statewide medication program for opioid use disorder, offering all three FDA-approved medications in its prisons.
Within the first year of implementation, the state saw a 61% decrease in the rate of overdose deaths for people who had left prison within the previous 12 months. In the years that followed, researchers continued to see evidence that the program led to a reduction in overdose deaths.
In addition to wanting to expand medication to all of its prisons, like Rhode Island, Violette said increasing funding could also help Connecticut’s DOC add staffing and create spaces focused on counseling.
“Correctional facilities were not necessarily built for counseling,” she said.
While Stoney appreciates the availability of medication at York, she doesn’t feel like she’s receiving adequate mental health treatment to address the underlying trauma that led her to opioids in the first place. She started using fentanyl and crack following the passing of her 4-month-old daughter, who died in 2016 due to Sudden Infant Death Syndrome.
Stoney was serving a previous stint behind bars at the time of her daughter’s death. She was placed on suicide watch at the time, she said, and didn’t receive any counseling. When allowed to go to her daughter’s wake, she said it was only for an hour, and physical contact was prohibited. She began using opioids for the first time once she was released.
“I went from not doing anything to becoming a drug addict overnight,” Stoney said.
Lewis said he has been diagnosed with post-traumatic stress disorder and bipolar disorder. He attributes his PTSD to his upbringing and the tough environment he grew up in.
“Growing up in the streets, being incarcerated, and just my lifestyle period. Using drugs at a young age so much, it’s like my mind didn’t develop right,” Lewis said. “I wake up in here sometimes, not knowing what the next day is gonna be like.”
According to a 2023 report by the Connecticut Sentencing Commission, 32% of people incarcerated in Connecticut have an active mental health condition requiring treatment, while an additional 41% have a history of a mental health condition not requiring active treatment.
The situation is particularly stark for incarcerated women, 81% of whom have an active mental health condition requiring treatment, compared to 28% of men.
“In jail, we don’t get any kind of counseling,” said Stoney, who feels like staff don’t want people discussing their trauma. “They don’t want us to come back to our cell and have triggers after what we talked about.”
During Lewis’ time behind bars, he said, the DOC offered counseling specifically geared towards addressing addiction but not mental health treatment.
“They give you methadone; they leave,” he said.
Andrius Banevicius, the DOC’s public information officer, said in a written response to questions that people on MAT while in custody are offered the same range of mental health services as everyone else, which includes outpatient and inpatient mental health services, psychotherapy and group therapy. The agency’s Mental Health Services Unit offers clinical assessments and establishes individualized treatment plans.
“It is difficult to speak to specific incidences related to an individual's mental health treatment. The important thing is that they were offered (and took advantage of) counseling for their addiction issues,” said Banevicius when asked about Lewis and Stoney’s perspectives on the lack of mental health treatment.
Kevnesha Boyd, a licensed professional counselor who worked as a mental health counselor for the DOC between 2015 and 2019, believes that substance use treatment must include mental health treatment.
“They’re one and the same. Having a substance use disorder is having a mental health condition,” she said. “The research is really clear that people are using substances to cope with severe and significant mental health issues. And we have to acknowledge that as a mental health condition and treat it as such.”
In the state’s jails and prisons, substance abuse and mental health are managed under two separate units, but Violette said the units work together.
“We do have co-occurring programming that we do at almost all of our facilities, and we very much collaborate with the mental health and substance abuse treatment for the offenders,” she said. Banevicius added that the units collaborate at some facilities to run co-occurring groups and that the mental health unit also collaborates with “DOC discharge planners, MAT services and inmate care in general.”
Boyd said she would like to see the mental health and substance use treatment units merge so that people receive more holistic treatment. There’s also a need to retrain correctional staff, she said, to properly treat the root causes of addiction, from personal trauma before one’s incarceration to trauma caused by the conditions of confinement.
“During my time there, we never had meetings with the substance use providers,” Boyd said. “We really need to get more wrap-around, right? More of the primary care doctor, mental health provider, substance use provider in the same room, really having collective conversations about how to meet the needs of incarcerated people.”
“Honestly, I can't say I'm proud of my recovery yet. The real accomplishment will be if I continue with my recovery upon my release.”ANJOLINA STONEY
Even though the methadone has helped Stoney with her addiction, she said she feels like her sobriety only counts for so much in prison. She knows the outside world will likely present a much tougher challenge.
“Honestly, I can't say I'm proud of my recovery yet,” Stoney wrote in a recent letter, explaining that she feels like prison is a controlled environment where she has no choice but to stay sober. “The real accomplishment will be if I continue with my recovery upon my release.”
The reentry system
The process of reentry, the transition from incarceration back into the community, can be extremely challenging to navigate, especially for people who are also managing addiction.
Violette, the DOC’s director of addiction services, said that discharge planning is a major focus for the agency, starting at the point of entry into the agency’s custody.
“Everyone who leaves our system has a discharge plan. We start the discharge process when they walk in the door,” she said.
Violette said the department focuses its discharge planning efforts on people awaiting sentences in jail, which she said is more complicated than discharge planning for people serving out their sentences in prison.
Discharge planning for people in prison starts 60 days before their earliest known release date, according to the DOC. A reentry counselor “will ensure” that people get an ID, register to vote, connect with potential employers, and will provide them with a list of resources available in the community they settle in. For those with more acute health needs, a medical discharge planner will do things like set up prescriptions and doctor’s appointments.
But for Lewis, “that never happened,” he said.
He left Osborn in February 2023 and now lives in a New Haven halfway house. He said he was set up with a methadone provider around the corner from the residence but that his discharge planning didn’t go much further.
Lewis was able to get an ID and social security card before he was released, but he said no one offered to help him. He initiated the process himself and followed up several times over the course of three or four months.
Even though Lewis feels like the state failed him, he does have one source of consistent support: his older sister, Stacy. She struggled with drug use as well but has been sober for more than three decades. They talk on the phone often, and he calls her when he feels overwhelmed.
“That’s my go-to person. She lets me know it can be done,” Lewis said.
When Boyd envisions what an intentional discharge process could look like, she imagines a process that connects people with resources for everything from substance use and health care to spirituality and exercise.
“We don't set these things up for, again, the most vulnerable population ever, and then the expectation is: thrive,” Boyd said. “This money can really fill in a lot of those gaps.”
The Connecticut Mirror spoke with five people who have been incarcerated in Connecticut prisons and with several others who work closely with people who are incarcerated in the state. All of them said that discharge planning is extremely limited or virtually nonexistent.
When asked what part of the reentry process should be the priority, the answer was unanimous: housing.
“That’s what everybody wants. It’s what everybody needs,” Lewis said.
Lewis has been in the New Haven halfway house since his release more than a year ago. He said the environment can get chaotic, with people constantly getting into fights. Originally, he thought he’d be living there for only a few months before finding an apartment or a bed at a sober house.
“If I could just get my own apartment and just get away from people, my sobriety would be good. I’d stay clean,” he said. “I could probably sleep a little bit better.”
There are a slew of bureaucratic barriers that make obtaining housing particularly difficult for someone coming out of prison and managing addiction.
Few people leave prison with enough savings to pay the security deposit, and two months of rent are often due upfront for an apartment. People convicted of certain crimes can, by law, be turned away by landlords and denied rental assistance. And in the vast majority of cases, people must pay out-of-pocket for a bed in one of the state’s credentialed or certified sober houses.
If I could just get my own apartment and just get away from people, my sobriety would be good. I’d stay clean.”MARCUS LEWIS
During last year’s legislative session, reentry was a major focal point as advocates called on the state to reinvest funds from recent prison closures into services for people transitioning back into their communities, which still has not materialized in the ways they would like.
Lawmakers also grew frustrated with the fact that people were leaving the DOC’s custody without ID, prompting the legislature to pass a bill addressing the problem. Leaving prison without an ID can pose significant challenges for people, from applying for a job to opening a bank account to renting a home.
The DOC said it is still facing challenges implementing the ID law, which mandates that the agency and the Department of Motor Vehicles ensure that a person receives an ID card by the time of their release unless the individual notifies them in writing that they don’t wish to obtain one or if they’re ineligible.
Ashley McCarthy, the director of external affairs for the DOC, attributed some of the challenges to “complications around the purchasing process for renewals and duplicate IDs.”
Aside from that, McCarthy said, the COVID-19 pandemic has dramatically altered the landscape of reentry services by making it more difficult to connect people to resources.
“There’s a shortage of those professionals that are in the community and are able to work alongside the population that we serve, so it gets challenging in those ways,” she said.
‘They’ll put a Band-Aid on it’
Around the state, there are a handful of people with lived experiences of incarceration and addiction running programs in communities designed to address what they see as the root of the issue.
Rick DelValle owns and operates six sober houses in New Haven and one in Hamden. He saw a need to provide short-term housing for people in sober houses who get kicked out following a relapse and opened Redemption House in 2020 to fill that need, though he’s since had to close it due to a lack of funding.
In Hartford, Edward Andrews founded the Second Chance Reentry Initiative Program, or SCRIP, a reentry program that, among other services, provides mental health treatment to address the trauma that leads many people to drug use.
Boyd, the former DOC mental health counselor, said she thinks there is “zero chance” that the opioid settlement funding will go towards helping justice-involved people. But if it does, she would like to see the bulk of it go towards community services, like those run by DelValle and Andrews, and not the Department of Correction, which she believes hasn’t shown that it has the structure to serve the medical needs of incarcerated people.
“Unless they’re going to revamp the whole system, which obviously they’re not invested in, I think it would be a waste,” Boyd said. “They don’t do anything with the budget they get now, so I think the money needs to be centered in more community services.”
When asked whether people impacted by incarceration would be a priority when considering the disbursement of the opioid settlement funding, Kaitlyn Krasselt, a spokesperson with Gov. Ned Lamont’s office, deferred comment to the Opioid Settlement Advisory Committee, or OSAC, and the Department of Mental Health and Addiction Services.
Chris McClure, speaking on behalf of OSAC, said in an email that the advisory committee is reviewing a “myriad” of recommendations for how the state should use the opioid settlement funding, which includes increasing access to MAT and other support services during and after incarceration.
Scott Semple, who served as DOC commissioner under Gov. Dannel P. Malloy’s administration, said he thinks there could be alternative facilities separate from prisons that focus on addressing addiction-related issues for people like Lewis, whose crimes are exclusively related to their substance use disorder.
“Those people that are doing these minor things in order to support their habit, there could be, in my view, a more comprehensive way in dealing with that,” Semple said. “That, I think, would be a really good step in any type of investment.”
Like Boyd, Lewis doubts that much of the $600 million in opioid settlement funding will go to people affected by incarceration. And even if it does, he is skeptical that the state will fund solutions that go beyond medication, like enhanced reentry support and mental health treatment.
“They’ll put a Band-Aid on it. They’re not gonna do surgery on it,” Lewis said of the crisis.
The lack of institutional support frustrates Lewis, but he said he is committed to staying clean.
“I want to die from old age. I don’t want my kids burying me because I had an OD,” he said.
And he is starting to see signs of progress towards the life he wants for himself.
“It’s starting to come, but I had to kick in doors on my own,” Lewis said. “People will push you off to the next person, push you off to the next person, which is not right. That’s not fair, especially if the funds are there for people to get help.”
