As one may imagine, institutions that carry out drug-related criminal sentences have a high population of people who are incarcerated while actively addicted to legal and illegal drugs. Some of these include heroin, cocaine, alcohol, prescription narcotics like oxycodone and hydrocodone, and benzodiazepines like clonazepam and alprazalom.
Individuals who have purchased these off the street may have exposed themselves to very large doses for a long time and their bodies become dependent on these substances. Mental and physical addiction are separate issues that often occur together, but physical addiction is a situation of one’s body being dependent on a substance, and suddenly stopping that substance can lead to withdrawal.
Withdrawal is more than craving a drug, experts say. It can manifest itself physically through psychosis, tremors, vomiting, diarrhea, dehydration, and seizures. Suddenly being cut off from alcohol or benzodiazepines increase the risk of seizures and in some cases may lead to death. While withdrawal is never pleasant, many are unaware that it can, in fact, be fatal, and should be done under close medical supervision. This is often accomplished in drug treatment centers and hospitals, but what happens in correctional facilities, where drug use is strictly monitored, even when it has been prescribed to an individual?
Utah jails are facing issues with treatment that correctional facilities around the nation are facing as well, says Jerry Costley, director of a drug treatment program in Salt Lake City. He says that many facilities are withholding treatments like methadone and suboxone for opiate dependency and that it needlessly puts people at risk for several adverse outcomes, according to The Standard Examiner.
“Without help for narcotics addictions while they’re behind bars, inmates are at risk for using when they get out, or overdosing when they get out. Even after we confirmed that our patients were legitimately prescribed these medications, even after we explained the risks to our patients of sudden withdrawal and even after our patients were in extreme discomfort.”
Costley said many jails are reluctant to handle the narcotics Methadone and Suboxone and seemed to feel that a punitive approach of withholding them was a better option for inmates.
“Their position seemed to be that suffering withdrawals was a legitimate part of our patients’ punishment. This was in spite of our offer to bring in the medication at our cost.”
Utah jails, as well as others across the country, do have legitimate concerns about the safety and intricacies of medicating inmates with such drugs. Since the drugs are highly sought after in jail, they pose a security risk to those who have access to them and to those who take them. There have been instances where inmates “pocket” the drugs prescribed to them in their gums in order to spit out and give to other inmates, either for money or because of intimidation tactics from other inmates who want them. They also could potentially hoard the medications if they are not carefully watched and use them to purposefully overdose by taking them all at once.
Vivitrol is a drug that shows promise, health department officials in Salt Lake City say. It’s injected monthly and actually blocks opioid receptor sites, so there is no chance of overdosing on it. However, it’s very costly, as much as $1,500 per injection, and many inmates can only receive it with a court order.
“Vivitrol seems to be a safer alternative to methadone because it completely blocks the receptors that give the high from opiates. Vivitrol is also a monthly injection, with methadone being dosed daily. I can’t imagine anyone would want to abuse it.”
Currently, 141 inmates are being treated with Vivitrol in Utah.
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