Surging heroin use brings increasing number of detoxing inmates

The heroin epidemic’s strangle hold on the state has prompted marches, increased the number of treatment facilities and drained funding for emergency responders dolling out narcan to bring back those who overdose from the drug.

But in area jails, it is just one more challenge, along with mental health, medical conditions and addictions to a multitude of drugs.

“I wouldn’t say it (heroin) is a unique problem, but it is a fairly extensive problem for people we book into the jail,” said Butler County Sheriff’s Chief Deputy Anthony Dwyer.

The county jail on Hanover Street in Hamilton can house approximately 900 inmates, the majority of which have some kind of physical or mental health issue as well as addiction, Dwyer said.

Butler County Sheriff Richard Jones and jail personnel are part of a lawsuit filed in federal court by the daughter of a woman who died in the jail in 2012, apparently due to complications with opiate withdrawal.

Attorneys allege jail officials ignored Ruby Farley’s complaints for medical attention, which led to her death. Farley, 52, was in Butler County Jail on a contempt of court charge in March 2012 when she was apparently was suffering from opiate withdrawal but jail guards allegedly did nothing to help her, according to the lawsuit.

The complaint filed by Farley’s daughter, Holly Candace McConnell, alleges Farley threw up her lunch and starting “moaning and screaming for help.” At one point, she also fell down and hit her head on the floor, but a deputy just left her there, according to the complaint.

A 2002 study by the U.S. Department of Justice found more that two-thirds of jail inmates were found to be dependent on or abuse alcohol or drugs. Two in five inmates were dependent on alcohol or drugs, while nearly one in four abused alcohol or drugs, but were not dependant on them.

Of the the hundreds of thousands of individuals entering the nation’s jails and prisons each year, it is estimated that approximately 15 percent are addicted to heroin, according to a 2007 report from the U.S. Department of Health and Human Services.

Withdraw from heroin can involve violent vomiting and other physical conditions that users term “dope sick,” but both Dwyer and Maj. Barry Riley, Warren County Jail administrator, said withdraw from chronic alcoholism is by far the most dangerous for the user.

“Heroin is a tough drug to come off of,” Riley said. The Warren County facility can house 280 inmates and usually is at or near capacity. “And we are seeing a lot more addicted to heroin because it is the drug of choice right now.”

Riley said jail doctors can prescribe Ativan and Librium to help inmates feel “more comfortable” when going through withdraw. In extreme cases, he said, the inmate can be moved to a hospital or treatment facility.

In the past year, the Warren County Jail has also played host to the Vivitrol program started by Warren County Common Pleas Judge Robert Peeler to combat opiate addiction.

The drug, approved for use by the U.S. food and Drug Administration in 2010, blocks receptors to the brain to prevent the person from feeling the effects of opiates, including heroin and morphine. The first shot is administered in jail and patients are monitored afterward through the court and outpatient treatment.

Since Peeler ordered the first treatment for a teen addicted to heroin who indicated he was willing to do “anything” to kick the addiction, it has been administered in the Warren County Jail approximately 25 times.

Middletown Police Sgt. Richard Bowling, supervisor of the city’s 72-bed jail, estimated about 70 percent to 80 percent of people booked into the jail are suffering from addiction — mostly heroin.

“They are either on drugs or stealing to get drugs,” Bowling said.

All three facilities have nurses, paramedics and doctors who care for inmates regularly. Cell checks are made hourly, and medical screens are conducted at booking, according to officials.

Dwyer said it’s important for inmates to be truthful during medical screens, but for various reasons that doesn’t always happen.

“You will get it both ways — those who downplay their addiction because drug problems can restrict your ability to certain access in the jail … Then others will exaggerate how dire their addiction is because they believe they are going to get some special treatment or drugs that help with withdraw,” Dwyer said.

The Butler County Jail has a medical and dental unit that is manned 24/7 by a paramedic or nurse. A doctor also visits several times a week. The jail’s medical staff is obligated to take care of medical needs for those booked into the jail, whether it be an abscessed tooth, broken hand or heroin withdraw, Dwyer said. Doctors at the Butler County Jail also administer drugs to help lessen the effects.

“If we think they are being less than truthful about a condition or if they have ingested something prior to booking that can be dangerous, we can place them on additional observation,” Dwyer said.

Body cavity searches are rare and require a search warrant, according to Dwyer.

Corrections officers usually try to talk with an inmate suspected of downing drugs that could endanger their health.

“Or we put them in a cell, turn off the water and let nature take its course,” Dwyer said.

Bowling said in Middletown many inmates are repeat offenders, who are known to staff.

“But they will still tell you “no, no I don’t have a drug problem.” That’s when observation is important,” he said.

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