PROVIDENCE, R.I. (SBG) - The opioid epidemic has taken hold of huge chunks of our nation.
It is killing people, destroying cities, and impacting crime rates and the quality of life for millions of Americans.
The "homeless crisis" is a drug crisis.
Citizens know it. The people you see camping and living in filth know it, too.
"I would say that 100 percent of the people I have met out here are experiencing some level of addiction,” one homeless woman told us.
On the West Coast, the use of opioids has essentially been decriminalized and the ripple effect on communities has been profound.
But in the tiny state of Rhode Island, aggressive yet compassionate steps are being taken.
"We can't ignore our way out of this,” said Dr. Jennifer Clarke. “People are dying and there's something we can do to stop that.”
It starts here, behind these walls, at the Rhode Island Department of Corrections.
"Because if you wake up in prison, you know you have a problem,” said Substance Abuse Coordinator Lauranne Howard.
There are three opiate blockers that work and are FDA approved: methadone, suboxone, and vivitrol. The blockers help get people off of heroin and save lives.
And every day, inside this prison, those medications are doled out to inmates through the MAT program which stands for Medication Assisted Treatment.
"Really, this is the perfect setting because there's not as much distraction, actually,” said Linda Hurley from CODAC.
The state hired an organization called CODAC which distributes the medicine inside and outside of the prison.
"And then once I found opiates, that was the end of it, you know,” said inmate Ray Vincent.
Ray Vincent spent the last three years behind bars for drug-related crimes. Getting arrested, he told us, saved his life.
Michael Manfredi did heroin for 35 years. 20 years of his life were spent in and out of prison. He remembers the nights, in prison, that he started using Vivitrol.
"One night I got a call,” Michael said. “It was about 6:30 p.m. and I was told to see the nurse. I had tears in my eyes because I knew it was time for me to get that pill.”
The inmates in the MAT program have counselors. There are one-on-one meetings with recovery coaches and group meetings as well.
"I have a social worker, psychiatrist, case manager, all in one facility that I see,” Michael Manfredi said.
It worked for Michael. Today, he has a job. He has reestablished relationships with his family.
"I think it's definitely what has to happen and should be happening everywhere,” Medical Program Director, Dr. Jennifer Clark said."
The key to what Rhode Island is doing is the bridge -- The transition from the penitentiary to the streets.
"93 percent of the people who leave here on MAT are following up in the community, said Lauranne Howard."
"Would I be where I am today if this program wasn't implemented?,” Michael Manfredi asked.
“No, I wouldn't be here today if this program wasn’t, he responded. “Honest to God, I'd be dead.”
In tiny Rhode Island, the cure of opioid addiction is being met head on behind prison walls and out on the streets. The concept is simple. Deceptively so. Drugs in prison. The drugs that get people off heroin. Jailed offenders don't have to go through painful withdrawal. They choose the drug that works: methadone, suboxone or vivitrol.
There are recovery coaches and counselors. There are group meetings and individual sessions. The mental part of addiction is attacked from every angle.
"The counseling definitely helps,” one inmate man told us. “You need somebody to talk to.”
Inmate Ray Vincent chose the drug Suboxone and is knows he may stay on it forever.
"You know, with all the counseling and all the support that I have, it's a very smooth transition, Vincent said. “I don't know how it would be if I wasn't on medication."
And here's the key: the program continues when they get out of prison.
"Priority number one, said CODAC's Leslie Barber, is how are they going to continue the medication?”
CODAC centers are sprinkled throughout Providence and Rhode Island. CODAC is the bridge from the inside to the outside.
"Once you come into the Department of Corrections and are medicated under methadone or suboxone, or vivitrol, you become a CODAC patient,” said Leslie Barber. “You have a patient I.D. number in our system."
There are 7 CODAC centers throughout the city of Providence. Former inmates show up any time, any day, and they get their medication with no questions asked.
The counseling and the group meetings continue on the outside, too.
"It is the right thing to do,” said Medical Program Director, Dr. Clark. “It is what we're obligated to do as health care providers. It's the smart thing to do.”
Manfredi has a job now. He's clean and happy. He is also head over heels in love with his granddaughter.
“I never been happier in my life," Manfredi said.
One way of measuring success is the death rate for those leaving prison. It's a dangerous time because addicts often get out of jail, start using drugs again, and overdose.
The rate of that happening is way down in Rhode Island.
"And what we found was a 65 percent decrease for mortality for people with a history of incarceration,” said Dr. Jennifer Clark.
The program is compassionate and it’s tough. But mostly, it's seamless.
"My life's great man,” Manfredi said. "And I can't thank everybody enough because if it wasn't for this MAT program, Michael wouldn't be here today.”
The MAT program started in 2016 at the Rhode Island Department of Corrections with a 2-million-dollar grant from the legislature.