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A judge in Ohio recently ordered an 18-year-old addicted to heroin, who was convicted of stealing, to undergo a series of injections of the opioid dependence medication Vivitrol. The move has sparked debate about whether this approach should be used more widely, and who would pay for it, according to USA Today.

Warren County Judge Robert Peeler said he came up with the idea after having three defendants die of heroin overdoses after he released them from jail early. “They died because I released them. It’s impossible to keep them all in jail,” he said. “There’s not a lot of rehab in jail that I’m aware of,” he added. “I just think that’s the best place to start.”

According to Peeler, the teen agreed to the treatment after being told he could have his conviction thrown out if he successfully completed drug treatment and three years of probation.

He received his first shot of Vivitrol on September 9, and was released from the Warren County Jail wearing a home incarceration monitor. He is being drug-tested randomly.

Vivitrol, also known as naltrexone, blocks the brain’s ability to get high on opiates such as heroin. It helps keep a person addicted to opiates from relapsing. It is also used to treat alcoholism.

Taxpayers would pay for a portion of Vivitrol treatment for inmates, because most prisoners don’t have private insurance, the article notes. The retail cost of the treatment is about $1,000 per injection.

Medicaid does not pay for the first injection, because inmates lose benefits when they are incarcerated. The county pays for inmates’ health care while they are in jail, according to the newspaper. “It’s an extremely expensive drug, and we certainly don’t budget for that drug in our jail,” said Warren County Sheriff Larry Sims.

If inmates are given their first injection while they are in jail, they have a month to obtain Medicaid benefits to pay for further injections, and set up drug counseling. Experts say Vivitrol treatment is more effective if it is paired with counseling.

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