dopetalk
Core Topics => Treatment, Recovery and Rehabilitation => Topic started by: Chip on November 07, 2017, 12:03:02 AM
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source: https://www.huffingtonpost.com/the-influence/us-jails-are-killing-people-opioid-withdrawals_b_9563940.html
U.S. Jails Are Killing People Going Through Opioid Withdrawals
Mar 30, 2017
(https://forum.drugs-and-users.org/proxy.php?request=http%3A%2F%2Fimages.huffingtonpost.com%2F2016-03-29-1459270996-4976357-PRISONBED_original.jpg&hash=db0375cde1f0929eeab89b622515a1fd93b053f2)
The overdose crisis has touched almost every corner of the United States. According to the CDC over 47,000 people died from overdoses in 2014, most from opioids like heroin, hydrocodone, OxyContin, morphine and fentanyl.
These deaths can be preventable with access to naloxone and education about overdose prevention and harm reduction. Most states have passed naloxone access and 911 medical amnesty (or “Good Samaritan”) laws in recent years. But that’s only the first step, and there are critical gaps in implementing those laws on the ground.
One of the widest gaps is in our corrections system. People are dying from overdoses in significant numbers shortly after they’re released, we know that. But they’re also dying within weeks of being arrested.
There’s a commonly held notion that withdrawal from opioids is a miserable experience, but not fatal. Once, when I was homeless and reached out for help, a treatment hotline told me I didn’t qualify for a bed in a detox program because “heroin withdrawal won’t kill you.” I was in jail within two weeks.
Fortunately, it didn’t kill me. But recent incidents at jails across the country demonstrate that opioid withdrawal, and the related symptoms, can be deadly. With proper medical care and access to evidence-based treatment, however, it needn’t be.
Dying for Help
Since 2015 there have been at least four prominent cases of people dying in jails from opioid withdrawal symptoms. Some symptoms, like anxiety, runny nose, muscle aches or insomnia, can be minor. More severe symptoms include vomiting and profuse diarrhea, leading to dehydration, and, in extreme cases, convulsions, seizures and delirium. In a closed setting with limited access to medical care, inadequate nutrition, and crowded, unhygienic conditions — as is the case in many county jails — this can yield potentially fatal results.
In March 2015, 18-year-old Victoria “Tori” Herr died in a Pennsylvania jail after being arrested on drug charges. According to several inmates, Tori was denied medical aid. Her mother told local news: “She was basically sentenced to death before she even saw the judge.” Her family started a Facebook group which now has almost 5,000 members.
In June 2015, 32-year-old David Stojcevski, a Detroit man enrolled in a medication-assisted treatment (MAT) program, died while serving a 30-day sentence for careless driving. His family has filed a lawsuit, citing an “excruciatingly painful and slow” death from “acute withdrawal from chronic benzodiazepine, methadone and opiate medications” and the incident is being investigated by the FBI.
In September 2015, 23-year-old Krista Deluca died in a California jail cell from what the Santa Cruz county coroner described as “severe heroin withdrawal symptoms.”
In January of this year, Kellsie Green, 24, died in an Anchorage, Alaska jail during heroin withdrawal. Her father says: “You go to bed at night and pray that your child will be arrested and taken care of. You hope this will be a second chance, not a death warrant.”
The Alaska Correctional Officers Association blamed the situation on jail medical staff — claiming that they refused to treat inmates or disagreed with assessments of corrections officers, and saying she should have been “in a hospital bed, not a not a prison cell.”
Chronic pain patients are denied opioid medications in most U.S. correctional facilities. And people with substance use disorders (SUDs) are widely considered to have a health condition which often requires medical treatment, but are almost universally denied care, which groups like the ACLU consider a violation of the Eighth Amendment to the U.S. Constitution.
The Federal Bureau of Prisons has detoxification guidelines for withdrawal, which describe a protocol of librium (a mild sedative) and clonidine (a blood pressure medication), with regular checks by medical staff. Most U.S. inmates, though, enter county jails, which aren’t subject to federal guidelines.
One county jail in Florida and jails in Rhode Island, Baltimore City, Seattle and Philadelphia, provide MAT to inmates, but most jail and prison officials don’t view treatment — including maintaining MAT for patients like David Stojcevski — as their responsibility. Yet continuity of treatment and access to medication for people with opioid use disorders are critical both for post-incarceration success and to give inmates the best chance of staying alive.
Benefits of Continued Treatment During Incarceration
Studies overwhelmingly associate proper medical care and continued access to MAT with positive post-release outcomes.
A 2009 study published in the Journal of Psychoactive Drugs confirmed that opioid-dependent inmates who were denied MAT or other medical care not only suffered unnecessarily, they engaged in “a variety of unhealthy behaviors designed to relieve withdrawal symptoms,” created unhealthy and uncomfortable conditions for fellow inmates, and were less receptive to MAT upon release. The study confirms the need to either provide supervised medical detoxification or MAT for these inmates.
A 2015 study of Rhode Island inmates in MAT programs showed that inmates maintained on methadone during incarceration were “more than twice as likely than forced-withdrawal participants to return to a community methadone clinic within one month of release.”
“You go to bed at night and pray that your child will be arrested and taken care of. You hope this will be a second chance, not a death warrant.”
A long-term (1985-2012) Australian cohort study published in 2014, with over 16,000 subjects, followed inmates with a history of MAT as they entered and left prison. The study revealed that the “lowest post-mortality was among those continuously retained on [MAT].” It also showed the highest risk of death occurred in the group which received no MAT. The study’s data models showed a 75 percent reduced risk of death after exposure to MAT programs within the first four weeks of release.
Data from the same study showed that in the first four weeks of incarceration, those maintained on medication were 94 percent less likely to die from all causes, while long-term results showed the same population was 75 percent less likely to die over a longer period, resulting in an overall 87 percent lower likelihood of death for medicated inmates.
Numerous other studies (here, here, here, and here) associate MAT with reductions in mortality, illicit substance use, property crime, recidivism and health problems like HIV and hepatitis C.
(https://forum.drugs-and-users.org/proxy.php?request=http%3A%2F%2Fimages.huffingtonpost.com%2F2016-03-29-1459270248-4574258-graph.png&hash=2888891ab0a5d6ea36c0c651f48bbdc88ae6ffbb)
This graph shows the reduction in “crime days” for people undergoing long-term methadone maintenance treatment.
Releasing Inmates With No Safety Net
Many people with SUDs already face obstacles navigating daily life, like maintaining a job, stable housing, education, and vital relationships with family and friends. Formerly incarcerated people face all of these obstacles upon release, and others, too.
A condition know as Post Incarceration Syndrome (PICS) is associated with many people released from jail or prison. Researchers have suggested* this condition be included in the DSM-5 as a subtype of PTSD.
A 2013 study published in the International Journal of Law and Psychiatry showed that, in addition to PTSD, formerly incarcerated people exhibited “institutionalized personality traits resulting from incarceration; social-sensory deprivation syndrome and temporal and social alienation.” Added to external difficulties, such as finding steady employment and housing, and restoring relationships, PICS can create a perfect storm of harmful conditions, which might contribute to relapse. Terence Gorksi, a pioneer in addiction studies, specifically indicates “reactive substance use disorders”** as an element of PICS.
“Naloxone is a lifesaving rescue medication which can reverse overdoses from heroin and other opioids, but nearly every jail or rehab sends at-risk people home without it.”
Jails and prisons fail to maintain inmates who enter the system on MAT, deny them opportunities to obtain MAT during incarceration, and release them without the resources they need to survive and recover. Naloxone is a lifesaving rescue medication which can reverse overdoses from heroin and other opioids, but nearly every jail or rehab sends at-risk people home without it.
Encouragingly, New York State established a pilot program in 2014 to train inmates to use naloxone and, upon completion, leave with a naloxone rescue kit. In 2015, the Durham County Detention Facility became the first jail in the Southeast (a region with one of the nation’s highest overdose death rates) to provide naloxone to released inmates.
But these are exceptions. Even in areas where third parties equip jails with naloxone for released inmates, it often goes unused.
Missed Opportunities
Correctional institutions, which ostensibly exist to protect us, serve as a key contact point for at-risk populations. When they fail to equip inmates with survival tools, educate them about harm reduction and overdose prevention, or provide critical reentry services, they’re complicit in the cycle of recidivism, continued suffering from substance use and PICS, and the wave of drug-related deaths in the U.S.
Jails and prisons have a unique opportunity to serve people in need of treatment and divert them from harmful behaviors. But right now, almost every step they take reinforces an incarcerated person’s reasons for using substances.
A drug-related jail or prison term shouldn’t carry a death risk. And rather existing merely to punish, the corrections system should provide incarcerated people with the tools they need to reintegrate into society and live healthy, productive lives.
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Like a goddamn dog.
My county is guilty.
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it's a country of extremes, I have been there. I am sure that it happens here too but isn't spoken about. the lawmakers think it's like a bad case of the common cold.
a jailhouse Methadone CT would have to be the closest legal thing to torture in a civilised society.
things have to change.
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...the lawmakers think it's like a base case of the common cold...
Yes - that is a *very* often heard (& believed) myth that really needs to die - opiate withdrawal consists of far more than 'a case of the flu that goes away after a few days'. I think a lot of people think this, and then think 'Then why is it supposed to be so hard to quit if it's just like the flu for a couple of days?'. *sigh*
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Yeah they do not care if you are kicking off drugs. Ive had friends have strokes in county from the jail medical refusing to provide their proper meds. THey now have a speech impediment ,and have a very hard time with most things involving language. In fact they can no longer speak Italian becuase the stroke affected that part of their brain.
I did a cold turkey detox in county. I finally bonded out 3 weeks after being locked up. I WAS STILL KICKING. Ive never been so cold. Made me realize hell isnt always hot and fire. Air conditioner blowing full blast, in the middle of winter. To top off this icy hell, the night I arrived, two people died in my pod. Apparently they were dead for a day or more before they figured it out. SO as a new policy we were no longer allowed blankets, so they could check to see if we were dead easier.
ONe particular instance sticks out in my mind, there was no toilet paper anywhere my 2nd day there. no good when ur puking and shitting urself every 10 mins. I asked a Correctional officer supervising the POD if i could get more TP. He proceeded to tell me "Nah, i aint getting you junkies shit. Tell you what, after you take a shit, stand up, and spread ur ass cheeks, and walk to the shower." Im not sure what i will do if I run into that Man outside one day.
Another horrible thing was seeing the methadone clinic come everyday and dose people who had been signed up before being locked up. Resulting in me withdrawaling like crazy next to a bunch of people nodding out and scratching themselves.
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Been there. Best thing to do is to keep to yourself and try not to make a spectacle of yourself, as you won't get any sympathy, especially if you are in holding cells and going from jail to jail dealing with holds due to warrants (as I was). Things eventually improved when I got into an actual pod. There was someone in there kicking methadone who couldn't even get out of bed, other inmates had to bring him his meals, etc. Another kid was kicking benzos and losing his mind, they wouldn't give him anything I recall.
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Benzo withdrawal is brutal and potentially life threatening so I thought thay it was common knowledge and hospitalisation was mandatory ... copied from elsewhere:
The risk of grand mal seizures from benzo withdrawal is higher than with alcohol withdrawal and can result in death. Benzo withdrawal also has significant psychological symptoms that can be life-threatening. ... The psychological symptoms of benzo withdrawal include: Anxiety and panic attacks.
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Benzo withdrawal is brutal and potentially life threatening so I thought thay it was common knowledge and hospitalisation was mandatory ... copied from elsewhere:
The risk of grand mal seizures from benzo withdrawal is higher than with alcohol withdrawal and can result in death. Benzo withdrawal also has significant psychological symptoms that can be life-threatening. ... The psychological symptoms of benzo withdrawal include: Anxiety and panic attacks.
This happened not too far from me:
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repped for making it real.
those images will never leave me.
they hate us ! i'm angry now.
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repped for making it real.
those images will never leave me.
they hate us ! i'm angry now.
(Not sure how to put in the video from youtube, but heres the link.) THis is a story that i came across a few years ago.. Tyler Tabor was arrested on a warrant, and bond was set at $300. His parents decided to not pay the bond so that Tyler would kick the drugs. Little did they know, the jail did absolutely nothing to help Tyler.
Tyler died of dehydration. He was the 5th person to die in that jail from withdrawal...in only 8 months The jail murdered him in my opinion. This is truly sickening to me.
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These stories always upset me to my core. So disturbing I have a hard time comprehending how the jails have no culpability?!?! It won't take compassion (obviously) but enough law suits might change things. Cash is king, not humanity.
Just to add to the reasons withdrawal can kill...heart attack. Not sure if that was mentioned or not so I figured it is worth mentioning. I was having colitis attacks that would have me throwing up for days (literally) 4-5 days straight. Finally was able to drive myself to the ER, and was told that my potassium level was so low, I was on the verge of heart attack. They gave it to me in pill form and IV form (burns like fire). Needless to say I was shocked to know this. Potassium=life and death.
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Yup - Potassium loss from losing fluids can be a killer... :(
And, yes - Potassium *does* sting like a MF upon IV administration (or so the Death Row end-of-the-road guys always say, anyway), I've heard. :o
It's the last thing you'd feel before having a *massive* heart attack (which are massively painful in themselves, apparently), if you were being put to death by lethal injection in America because it's the Potassium OD that's supposed to be the main killing agent.
There was a great TV docu show that was presented by some British twerp who used to be something in government - Michael Portillo - that's his name - and he presented this really good show about the death penalty in America. He went over the different methods, talked to the guards who perform them and the 'technicians' who set it up, and also hilariously visited a Dutch Air Force simulator where they had him doing children's coloured blocks while they drained all of the air from the room (well, increased the CO2 actually), and it was really funny watching him giggle and flop about unable to complete the simple tasks or respond.
They also showed pigs being given some noble gas - Argon IIRC, and the pigs just fell over all of a sudden, and were back happily on their feet eating apples seconds after they started pumping O2 back into the room.
The main conclusion seemed to be, anyway, that the American methods of killing prisoners are really inhumane, painful & degrading, and are more done for the 'justice' of 'giving something back' to the grieving families of murdered victims etc., than it was anything to do with 'humane execution'. *Huge* surprise there, I know.
The experts seemed to think that the best, and lest painful, least messy and quick method was the inert gas thing - just put prisoners in an air-tight chamber, and flood the chamber with Nitrogen, displacing all the Oxygen - the prisoner will quickly fall into a state of deliriously happy narcosis before promptly snuffing it within a minute or two. 8)
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Fuck Corizon, the prison health care company.
Here's another one, not necessarily "withdrawal" related but he was NOT properly medicated and they didn't care. Shocking.
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Fuck Corizon, the prison health care company.
Here's another one, not necessarily "withdrawal" related but he was NOT properly medicated and they didn't care. Shocking.
If you get locked up in a US jail, id avoid telling anyone ur kicking off opiates. Instead tell them that you are a heavy drinker, and usually drink A 5TH a day, and you get the shakes if you don't drink. They will treat you with more, because its a known fact that you can die detoxing from alcohol.
Usually they will give you a benzo and a few other extras they wont give to the opiate addicts. I also feel like im treated better when they can relate to the drug im taking, and everyone drinks. Way less stigma. So they treat me better than if i had told them i was a heroin addict.
Its still not a lot considering how shitty you will feel kicking. However it is better than nothing.
Just a little tactic of mine.
AND FUCK CORIZON. A friend of mine recently was arrested on a friday night on some bogus charges, and had to spend the weekend in jail untill he saw the judge monday morning to have the charges dropped. They refused to give him his proper psych meds, resulting in him almost dying. I bonded him out when he told me Saturday night he legit was afraid he was going to die. Hes not a weak person or a dramatic person, so i took this very seriously. By the time i got him out on sunday his Blood pressure was so high, im told he would have died spending another night.
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Yes, well known tactic to claim benzo withdrawal, although claiming any withdrawal at all puts you in a testy spot if you can't bond out or whatever.
Another little tactic that worked for me all 4 times I tried it, is to fake a seizure. I got out of the holding tanks of four separate jails doing this, even with probation violations and multiple DWLS, paraphernalia etc. charges, although they are all misdemeanors. They just took me to a hospital without escort and I either left AMA or stuck around til they okayed me to go, but I was able to sleep in my bed each of those nights. Protocol varies between jails but hey....
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Yes, well known tactic to claim benzo withdrawal, although claiming any withdrawal at all puts you in a testy spot if you can't bond out or whatever.
Another little tactic that worked for me all 4 times I tried it, is to fake a seizure. I got out of the holding tanks of four separate jails doing this, even with probation violations and multiple DWLS, paraphernalia etc. charges, although they are all misdemeanors. They just took me to a hospital without escort and I either left AMA or stuck around til they okayed me to go, but I was able to sleep in my bed each of those nights. Protocol varies between jails but hey....
The faking a seizure part is interesting. Supposedly i had a seizure my fiirst night locked up. I dont think anything was done. i dont remember it at all. The other inmates said i was flopping pretty bad tho. COs just saying shit like "you did this to urself, man up.". I bit my tongue pretty badly.
what additional charges did you get for leaving the hospital?
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That video just ate away at me....
I have zero doubt in my mind that I was extremely close to becoming another one of these horror stories.
The suffering induced by not receiving necessary medicine is amplified tenfold IMO, when you're in a setting like this. The anxiety ramps up, the walls close in. The vivid hallucinations become constant.... You're dying. Just, slowly.
When I went in on a 7mo Parole Violation in 2012, I was using (under the care of doctors) Methadone 120mg, Xanax 2mg and Neurontin 800mg daily.
The suffering was unreal.... The lack of empathy, was unreal.
I fell out, over and over again. I would become dizzy and I would fall. I could feel my body convulsing through my distant sensory. I could hear distant voices.
Then I would come to, the 3 men I shared my cell with becoming irritated with me, CO's accusing me of faking symptoms. Neglecting my verbal and then written pleas for help. For medical assistance. For medical aide.
Not for a high. Or a trip out of my cell.
I needed help. Because I was dying. Just, slowly. But they could not have cared less.
Instead of being placed in a medical wing of the jail, I was placed with the Main Line. It felt like every moment would bring something insane, or bring my own insanity. The disassociated feeling of WD was becoming my reality.
I lost 25lbs, which is a little for some. But is a lot for me. I couldn't eat, I could barely keep down fluids... I couldn't care for myself. My hygiene. And no one could have cared less.
I honestly feel like a came close in there. No words can really describe.... I'm just now finding this out. I can't explain it as adequately as I'd like to.
But I could feel that man's suffering. And it makes me furious that WE as a PEOPLE have decided that THIS KINDA SHIT IS OKAY!!!
Someone's son.... Someone's dad.... Someone's brother.
Gone forever.... Over a $772 dollar fucking fine!
Hope a pound of flesh will do, you fucking monsters.
(I've never met anyone as evil and soulless as a jaded County Jail C.O. The judgement they spew from their childlike mouths and the Kafkaesque pecking order are enough to make me wanna go hunt the MFers down like the true animals that THEY are.)
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what additional charges did you get for leaving the hospital?
None. I was released from custody at that point, so there was nothing they could do. Don't think the police even knew what ended up happening to me, not that they would have cared.
Actually, one of the jurisdictions didn't even give me a PR bond, they just literally cut me loose and nothing else ever came of it. Next time I got picked up elsewhere I had them run a hold check and that hold and warrant was cleared from the system. Maybe they just didn't want to deal with my BS anymore haha..
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what additional charges did you get for leaving the hospital?
None. I was released from custody at that point, so there was nothing they could do. Don't think the police even knew what ended up happening to me, not that they would have cared.
Actually, one of the jurisdictions didn't even give me a PR bond, they just literally cut me loose and nothing else ever came of it. Next time I got picked up elsewhere I had them run a hold check and that hold and warrant was cleared from the system. Maybe they just didn't want to deal with my BS anymore haha..
What all did you do for the faked seizures?You said the key is to do it in the holding cells during intakes?