Recent jail deaths raise questions about detox protocols

The recent deaths of two Bucks County inmates are raising questions about drug-detox protocols in prisons.

A Bucks County Courier Times and Intelligencer investigation found that over the last six months, two inmates have died while withdrawing from opiates.

In response, the county controller is calling for a review of the Bucks County Correctional Facility’s detox procedures.

David Damsker, the county’s health director, said what happened is unfortunate, but he thinks the jail is doing everything it can. Inmates often enter jail in poor health.

“People’s bodies aren’t taken care of and there’s always a risk of things happening to them within jail whether detox or not detox,” said Damsker. “But from what we can tell so far, there was no lapse in judgment or deficiency in protocols that caused the issues with the inmate.”

About one in four inmates in the county has a drug addiction. About a third of that group, or upward of 700 people, have some sort of opiate dependency, according to Todd Haskins, vice president of operations for PrimeCare, the agency contracted to provide medical services inside the county prison. PrimeCare also oversees care in about half of county jails in Pennsylvania.

All inmates are assessed within four hours of entering the facility, Haskins said. Staff come up with treatment plans, which may include medication to decrease symptoms at least three times a day. Detox lasts seven to 10 days, and medical staff are supposed to check in regularly.

Staff members do not administer methadone, except in the case of pregnant women, or Suboxone, a newer narcotic used in the treatment of heroin addiction.

Bryan Kennedy, who runs a nearby recovery house for men, said detox is extremely uncomfortable, no matter what, but he finds that people are often fearful to go through it in general. He hears stories from people waiting days in jails before going through an intake and getting a medical evaluation.

He also encounters people trying to seek treatment beforehand.

“At least in my working in this field, the individual will do whatever possible to try get into a treatment center detox, prior to having to turn themselves into prison or to be arraigned to go to prison, because they don’t believe prisons want to make it too comfortable,” he says, adding that accessing such treatment beforehand usually requires that a person have insurance.

The seriousness and severity of a individual’s withdrawal may depend on the length of use as well as the amount and combination of drugs involved, Kennedy said.

National surveys have found that many jails lack detox protocols. Researchers including Craig Haney, a psychologist at the University of California-Santa Cruz who studies incarceration, view this generally as “a huge problem,” with many prisons now serving as default centers for people with serious drug addictions.

“Line officers often don’t know how to identify at-risk drug addicts and don’t know the danger signs of a life-threatening detox,” Haney said in an email. “They are not trained for this and, unless there is good medical and mental health oversight and monitoring, these kinds of tragedies are bound to happen.”