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10Investigates: Knox County Jail Vivitrol Program

Inside the Knox County Jail, a drug called Vivitrol is marketed to inmates as a shot to turn their life around.

It has been more than two years since the jail started an experimental program to give a handful of inmates shots to help them use time behind bars to beat drug addiction. So far 30 inmates have been given the Vivitrol shots with mixed results.

RELATED (2/27/17): Vivitrol treatment program starts in Knox County

“Is it a complete success? No,” said Knox County District Attorney Charme Allen. “Is it a great step in the right direction? You could argue yes.”

While experts agree the shots help those battling addiction, questions remain about whether they are the most cost-effective treatment option and whether the drug works without also going to counseling sessions.

Vivitrol blocks the receptors in your brain so that you can’t get high for nearly a month after getting the shot. Inmates participating in Knox County’s ‘Shot at Life’ program are given their first dose while inside the jail. They are then released and go through counseling sessions with Helen Ross McNabb. It takes a year and a half to complete the program, getting one shot every month.

Marc Sallinger

“67% are still in recovery, not using, six months after the program,” said Allen. “73% of the individuals that we’ve run through have become gainfully employed. I think you can look at employment rate and that alone is a step in the right direction.”

The 30 inmates who were chosen had accrued 72 charges the year before beginning the treatment. Since then, only four have been arrested again, picking up 20 charges total. Most of the new charges are drug-related.

“It’s like anything. Some people are very successful in this program, some people are not,” said Allen. “We are trying to get these people who are addicted to be in recovery, stay in recovery. As long as they are in recovery, we think that the recidivism numbers will be extremely low.”

Former Sheriff JJ Jones started the program and it will be up to Sheriff Tom Spangler to decide whether to continue.


“It’s not that I’m skeptical, it’s just that we are still looking for numbers to see what it’s going to do,” said Spangler. “You’re looking at about $1,000 plus for each shot. So if you’re looking at 30 shots, there’s $30,000 right there already… when you go and ask people to start paying for that, that’s a lot of money.”

The program was funded by a grant which paid for the counseling sessions. The drug company provided 360 shots to the jail for free. But Vivitrol is costing the government, and taxpayers, millions of dollars in Tennessee.


In 2013, Tenncare paid for less than a million dollars’ worth of the drug. By 2016, the number had surpassed $12 million. Across the country, fueled in part by inmates signed up to Medicaid, Medicaid spending on Vivitrol jumped to more than $200 million in 2017. That’s up 2,500% since 2013.


Other addiction treatment drugs like buprenorphine, also known as Suboxone, are said to have similar relapse rates but are far cheaper. Here in Knox County, leaders attribute the programs’ success to the therapy sessions used in conjunction with the drug.

“Medication alone has proven to be not nearly as successful,” said Jerry Vagnier, President and CEO of the Helen Ross McNabb Center. “Every month they come for one shot. In addition to that, they come to intensive outpatient treatment three to four times a week, they meet with other people in recovery and a professional counselor to work on their skills and on their recovery.”

Success and failure

We first met Gregory Fox inside the Knox County Detention Facility when the Sheriff’s Office administered his first shot of Vivitrol in February of 2017. He was the first inmate in Knox County to get the drug behind bars.

“I couldn't tell you the last time I've actually been high," Fox said at the time. "I just do it to function basically. I basically just take pills to be able to work."

Soon after he was given his first shot, he was released and went into treatment with Helen Ross McNabb while also continuing to get Vivitrol shots.

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