[PROMPT: What is the scope of the challenge for jails?]
SHERIFF JAMES SKINNER: Two-thirds of the people inside my jail have a substance abuse disorder as opposed to 5 percent of the people on the outside.
CARRIE HILL, ESQ.: So as we've seen an increase in the number of individuals coming into our facilities with substance use, we know that part of that is also withdrawal. . . . That increases the potential for risk of some type[s] of medical complications and/or death. Our job is to try to address that.
SHERIFF PETER J. KOUTOUJIAN: I mean, we should understand that . . . number one, we have a mandate . . . to care for the health of those in our care and custody, but more than that, we have a responsibility to do that.
SHERIFF JAMES SKINNER: If you don’t deal with it properly, you’re going to have risk management issues. You’re going to end up in federal court for your negligence and your failure to do the right thing.
[PROMPT: What do sheriffs or jail administrators need to know about managing substance withdrawal in jails?]
CHIEF LAURA E. BEDARD, PHD: Jail administrators and sheriffs need to understand that substance use disorder is a medical issue. We need to do everything in our power to stop preventable deaths, and withdrawal deaths are preventable.
SHERIFF GABE MORGAN: It’s important to have effective policies, procedures, and protocol[s] to deal with all aspect[s] of one in the facility. . . . You have to look at addiction as, “This is a medical issue.”
SHERIFF NICHOLAS COCCHI: We're probably looking at anywhere between 12 to 14 to 17 hours. They are deeply in the state of withdrawals. It's important that we train our staff to helping these people get stabilized.
CARRIE HILL, ESQ.: Sheriffs and jail administrators know that they have a duty to protect and care for all of those living and working in their facilities, and part of that priority is screening individuals for medical and mental health challenges upon intake, including withdrawal. . . . So the sooner we can identify, the sooner that we can screen individuals and get them the treatment and medical staff involved, the greater our opportunity is to prevent any type[s] of medical complications and/or even death.
SHERIFF GABE MORGAN: To properly identify, screen, [and] treat is just so critical because . . . the [last] thing that we want is someone to die in our custody. And then the bottom line is that's a human life, and we are entrusted with their care.
CHIEF LAURA E. BEDARD, PHD: The challenge is really huge nowadays. . . . And we've had to—here at our facility, we've had to change that correctional mindset.
[PROMPT: Why are the guidelines important to implement?]
CARRIE HILL, ESQ.: These guidelines are going to help not only jail administrators and staff but also providers and, also really important, the community providers as well. This is a community problem. It has to be a community solution.
CHIEF LAURA E. BEDARD, PHD: The guidelines provide an opportunity for us to be consistent in our treatment of substance use disorders.
SHERIFF GABE MORGAN: This is a blueprint . . . to implement these policies, to utilize this protocol. It's a game changer, particularly when we're seeing more and more people coming into our facilities that are experiencing substance abuse withdrawal.
SHERIFF PETER J. KOUTOUJIAN: If there is a good practice out there . . . I want to utilize that. . . . What I really love is the fact that we don't have to go it alone.
CARRIE HILL, ESQ.: These guidelines will help sheriffs and administrators gauge where, in fact, they could enhance their current policies or protocols and services with their providers, [and] where there might be gaps.
CHIEF LAURA E. BEDARD, PHD: It'll provide rural jails, who may have a greater challenge in substance use withdrawal treatment, with a starting point. . . . And the guidelines will help us recognize when it's time to raise the level of care and hopefully prevent in-custody deaths from substance use withdrawal.
CARRIE HILL, ESQ.: These withdrawal guidelines are only going to help all of us to get to a better place, to help to recognize signs and symptoms with substance use withdrawal . . . and, most importantly, to save lives.
SHERIFF NICHOLAS COCCHI: It's about finding what works and letting everybody know . . . it's important that we get them from step one to the end step, which eventually is reentering the community, hopefully with a better foundation under their feet.
SHERIFF JAMES SKINNER: This is going to be a great resource. It's going to be good for everybody. And it doesn't matter the size of the jail. . . . At the end of the day, just remember, it's the right and decent thing to do.
