YORK, Pa. (AP) - Pat Sauble thought there were “10 out of 10 chances” that he’d be landing back in the state prison at Camp Hill.
He “got lucky.”
First, he was accepted into York County Drug Treatment Court. Then, he signed up to get an injection of Vivitrol: a non-addictive medication that prevents people from getting high from heroin or other opioids for up to one month. It also cancels out the pleasurable effects of alcohol. Sauble said he’s now able to focus on his recovery - and other “life stuff.”
“What the shot has given me the ability to do is to do what I couldn’t do for myself, all those times before,” said Sauble, a machine operator who lives at a recovery house in York. “It took the drug completely out of play. There’s no thinking about it. It’s not there.”
Sauble, 29, is one of at least 24 former inmates at York County Prison who have received the Vivitrol injection as part of a pilot program. It could be expanded to everyone who’s interested and eligible in 2017.
The medication blocks certain receptors in the brain, and it also helps reduce cravings. But even some who’ve benefited from the shot caution that it’s not a panacea to the heroin and drug overdose epidemic, which has killed more than 250 people in York County since 2014.
Growing up in West Manheim Township, Sauble was a student in the South Western School District and a promising soccer player.
He started smoking marijuana, and then sold it. That’s so he could have more cash, and use for free.
While in high school, he met a Mansfield University student, who introduced him to cocaine. Sauble started selling it for the man.
When Sauble found it hard to sleep, a friend gave him heroin: “’Hey, take a little bump of this, and you’ll go to sleep fine.’” He was about 16 years old.
His source got busted, so Sauble went back to selling weed, and he stopped using heroin. But one day later, he felt sick. “I had a habit,” he said, “and I didn’t know.”
So a friend rolled out a line of heroin for him. Instantly, he was better. “I was like, ’Damn, that’s crazy,’” Sauble said, adding he was “off to the races.”
Eventually, Sauble managed to stay clean for one year by “white knuckling it,” and thought he could just stop. But in Alcoholics or Narcotics anonymous, he noted, they tell you that the drugs had simply been the solution to whatever problem you had.
Sauble first got the injection on Sept. 16, and he’s received it at least three times since. With Vivitrol, Sauble said, he’s patient, and it’s allowed him to start building a support network and to give recovery a chance.
“It’s great. I hope they continue to push it at the jail,” Sauble said, “because that’s where most of us end up.”
Right now, staff members identify people who they believe could benefit. Those expressing a desire to go right back to getting high, for example, wouldn’t be good candidates. They also get recommendations from places such as the treatment courts. The program is set to expand to the rest of the jail, including for people who are in for short periods, Deputy Warden Clair Doll said.
The manufacturer of Vivitrol, Alkermes, provides the first injection for free. Employees set inmates up with medical assistance; give them the shot three days before they’re released; and schedule a follow-up appointment at Colonial House, a local drug treatment provider, he said.
Doll said offering the injection is the “right thing to do.” Even if only a few people take advantage of it, he said, those are lives being saved.
“In corrections, your success rate is not always very high. We have to celebrate the successes that we have,” Warden Mary Sabol said. “We’re not going to stop everybody from going back and using drugs, but five is better than none.”
People must receive counseling as part of the pilot program, as they will not be on Vivitrol forever, said Antoinette Sacco, the CEO of Colonial House. So clients, she said, will “need to know coping skills, how to handle relapse triggers and life on life’s terms.”
Alkermes also says the medication must be used along with some sort of treatment.
In Massachusetts, the Barnstable County Sheriff’s Office started offering Vivitrol to inmates in 2012.
Barnstable County Sheriff Jim Cummings said approximately 215 people have received the shot, and about half are still clean. It has reduced recidivism, he said, as only 28 percent of them have been locked up again - compared to about 60 percent on average.
“It’s something we’re really happy with,” he said. “I’m certainly glad to see that other correctional facilities are taking a look at it.”
Cummings said the injection works great in a correctional setting, because people have to be clean for at least one week before getting the shot. It also does not get you high.
The U.S. Food and Drug Administration approved the medication, naltrexone, to address opioid addiction in 1984. At first, it was available in daily pills.
So far, much of the evidence about the success of the monthly shot appears to be anecdotal.
“Overall, what I’ve seen in general, the folks that have used it have done pretty well, and it seems to have been a help,” said Common Pleas Judge John S. Kennedy, who has presided over York County Drug Treatment Court.
Assistant Public Defender Angela Fox-Holtzapple, who is assigned to York County Drug, DUI and Veterans treatment courts, said she’s also glad the shot is being offered, and that it’s making a difference.
For First Assistant Public Defender Clasina Houtman, her clients are typically able to get through programs fine in jail. The real struggle kicks in once they leave that “controlled, restrictive environment.”
Some have to start from scratch. They might have lost their job, lost their housing - and even lost all the furniture that was in their home, she said.
“You can give people all the treatment that they want - and it’s certainly a very important step,” Houtman said. “But if you don’t solve the other life issues, it’s almost like throwing money away. It goes hand-in-hand.”
Alyssa Rohrbaugh first learned about Vivitrol from her son, after he came home from rehab in Jacksonville, Florida.
Rohrbaugh, who’s the vice president of Not One More - York Chapter, said she’s a huge supporter of the medication. The organization runs a fund called Randy’s Wish, which helps cover the doctor’s appointment for the shot. She also brought it up to members of the York County Heroin Task Force.
“Of course, it’s not the answer,” she said. “But it’s a bandage.”
That’s a message that Robert Snyder wants to get out.
Snyder, 40, a manager at a fast-food restaurant who lives in York, has taken Vivitrol to help with his struggle with alcohol abuse.
In May 2015, Snyder was charged with driving under the influence. He lost his job. He came home after working third-shift, bought a “large amount of alcohol,” and wound up in York Hospital - with a blood alcohol content that measured 0.34 percent. That’s more than four times the legal limit to drive.
Snyder first got the shot in September at White Deer Run, where he learned that “this beer is not worth everything I have.” Vivitrol is a “security blanket,” he said, which can be used until someone builds up his or her support network.
The shot, he warned, should not be used as a “crutch.” Being sober and in recovery are different, Snyder said.
“Some people will take it and say, ’I’m good. I don’t have to do anything else. I’ve got the shot, I’m safe, I don’t have to do meetings, I don’t have to go to counseling, I’m just good to go,’” Snyder said. “And that’s so wrong.”
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