HARP
OVERVIEW AND PROGRAM OUTLINE MANUAL
Sheriff Karl Leonard Chesterfield County, VA Sheriff’s Office
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HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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Table of Contents 1. Heroin Background..................................................................................................... 2. Heroin Epidemic Overview........................................................................................ 3. Why HARP?.................................................................................................................... 4. What Distinguishes HARP From Other Recovery Programs?............................ 5. Types of Referrals........................................................................................................ 6. Overview of HARP Phases......................................................................................... 7. Participant Encouragement...................................................................................... 8. Program Setting/Living Spaces................................................................................. 9. Components Of HARP................................................................................................ 10. Medical........................................................................................................................... 11. Peer To Peer Counseling........................................................................................... 12. Community Services Board....................................................................................... 13. Professional Counseling Services ........................................................................... 14. Mental Health Services............................................................................................... 15. Break-Out Sessions (ACEs and Resilience Workshop and Rising Strong Curriculum).................................................................................................................... 16. K9 Therapy / Music Therapy..................................................................................... 17. Parenting Class............................................................................................................. 18. Family Night/Family Assistance................................................................................ 19. Open House.................................................................................................................. 20. Spiritual/Faith Based Recovery................................................................................. 21. Personal Letters Community Outreach & Prevention External Communications..........................................................................................................
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22. HARP Graduation......................................................................................................... 23. Off The Street Participation....................................................................................... 24. Employment Outreach, DMV Connect & Other Re-Entry Efforts.................... 25. Program Visits............................................................................................................... 26. Personal Investment & Buy-In Special Programs/Events.................................. 27. HARP Newsletter.......................................................................................................... 28. Tracking Success.......................................................................................................... 29. Phase II (Non Profit, Group, Off-Site Counseling, Peer Certification, Community Resources) 30. Program Costs.............................................................................................................. 31. HARP Participant Waiver............................................................................................ 32. Volunteer Agreement................................................................................................. 33. Sample Schedules.......................................................................................................
HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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Heroin Background
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eroin belongs to a class of drugs called opioids, which also includes the painkillers codeine and morphine. Heroin comes from a natural substance extracted from the seedpod of the Asian poppy plant. It usually appears as a white or brown powder. Heroin can be injected, sniffed, snorted, smoked, or taken in pill form. Injection of the drug provides the greatest intensity and most rapid onset of symptoms. Almost immediately upon injection, the user is relieved of physical pain and discomfort and experiences pleasurable feelings. This false sense of well-being plays a part in the addiction to heroin. When heroin is used, mental functioning becomes clouded as the central nervous system, heart, and breathing slow down. In the case of overdose, this decrease in functioning can cause death.
HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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Heroin Epidemic Overview
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eroin-related deaths jumped 39 percent from 2012 to 2013, and the longer-term trends are equally disturbing: from 2002 to 2013, the rate of heroin-related overdose deaths nearly quadrupled, according to the Centers for Disease Control and Prevention.
Heroin deaths even surpassed gun homicides for the first time, CDC data showed Opioid deaths continued to surge in 2015, surpassing 30,000 for the first time in recent history. That marks an increase of nearly 5,000 deaths from 2014. Deaths involving powerful synthetic opiates, like fentanyl, rose by nearly 75 percent from 2014 to 2015. In a grim milestone, more people died from heroin-related causes than from gun homicides in 2015. As recently as 2007, gun homicides outnumbered heroin deaths by more than 5 to 1. And in some areas, like Virginia, heroin deaths have surpassed traffic fatalities.
HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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Why HARP?
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eroin addiction is at epidemic levels as well as opiate overdoses and opiate deaths. Chesterfield County is not immune to this epidemic. It is here, it is now, and it is killing our sons, daughters, brothers, sisters, mothers, fathers, and friends. The Chesterfield Sheriff’s Office recognizes that substance use disorders are not a crime, rather a treatable illness. The current way we address opiate addiction in the jail is not working and we needed to do something different. We must end the addiction BEFORE they leave the jail. We must provide the tools to become and stay clean. And we must do it now. On March 8, 2016, Chesterfield County witnessed their tenth heroin related death for the year. That significant event was the turning point that became the impetus for us to begin our heroin recovery program, that very day. This is not an issue one can afford to run this through the normal bureaucracy of starting new initiatives or through normal budget request processes to obtain funding to start the program. We knew that if we went through these traditional normal routes that it would take several months and in that time how many more would die from heroin?
So that day we launched our program finding other areas we could take funding from to dedicate to this program. At first what we provided was a hodgepodge of recovery programs quickly developing a detailed curriculum delivered by experts in the various subject areas. The program grew and within weeks we exceeded capacity and relocated the program to another part of the jail allowing us the ability to increase participation significantly. While we were making great inroads with HARP there was always one area we felt we were not providing service to and that was with female inmates which we did not house at our jail. In September of 2016, a female who was processed in at our facility and was in active heroin withdrawal was sent to a nearby facility where she later passed. Knowing that we had to do more for our female heroin addicts, the very next day, September 22, 2016, we launched our female HARP and within weeks were at capacity in that program as well. This addition, later affectionately named by themselves as the “Harpettes” was long overdue and began immediately to help us address heroin addiction with the large female population we were seeing.
HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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What Distinguishes HARP From Other Recovery Programs?
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ARP is a very intensive and demanding recovery program that specifically addresses addiction from heroin only. (Other programs in the jail focus on all addictions to include alcohol).
It utilizes a myriad of therapeutic, medical, and educational approaches to overwhelm the addict with options and tools to use that best fit their individual recovery path and what works best for them. In HARP we accept the fact that addiction is a disease and not a crime and the participants have made some poor decisions in their life that were based on their addiction and the forces they are. We hold that these are not bad people who want to be good rather sick people who want to be well. HARP is also a voluntary program that only those committed to living a clean and sober life can apply to be part of. Once they apply a thorough screening process takes place to determine if in fact the individual is a heroin addict, and if they are determined to beat that addiction. This is accomplished through interviews from medical staff, HARP deputies, and most importantly a group of around 3 members(inmates) currently in HARP. Once accepted the individuals are quickly brought into HARP and begin their recovery that very day. There are three different points of contact in which potential program participants are screened: 1. Upon intake; 2. During the classifying process; and 3. During the medical screen. The Medical Department screens individuals for signs of chronic diseases and symptoms of withdrawals. Individuals are put on a protocol to assist them with the effects of withdrawal and are monitored until the symptoms cease.
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It is known that the best time to give someone help is at the very time they ask for it. For that reason, another distinction of HARP that makes it unique is that participants are both “pre” and “post” sentence which allows someone ready to recover to enter the program on the very same day they are incarcerated, even prior to a Bond Hearing or Pre Trial court appearance. In prior years, the Sheriff’s Office waited until conviction and in most cases, sentencing. This process took a great deal of time and resulted in most offenders being released as “time served” upon conviction without the chance to take advantage of programs. Offenders with current behavioral issues are not eligible. Those who are identified as unable to participate due to serious mental illness or who have medical needs may be prohibited from attending.
• Once in the program an advisory team is developed from within. Four pod advisors and two additional advisors (as nominated by the group members themselves) insure the program runs on schedule, and that participants are engaged and have the tools to understand and learn. In one case a special tutor was brought in to teach a participant how to read. They also serve as counselors and confidants and pay close attention to those who may be having bad days or suffering from a physical or mental illness that must be addressed.
HARP — OVERVIEW AND PROGRAM OUTLINE MANUAL
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