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SALT LAKE CITY — Salt Lake, Weber and Wasatch are the only county jails in the state that provide addicted inmates with long-term opiate withdrawal medication, a new report shows.
The Salt Lake County Jail is the only facility in Utah that uses all three medication types approved by the Federal Drug Administration for long-term treatment of opiate dependence — including methadone, buprenorphine and naltrexone. The Weber and Wasatch county jails provide just a few types of these medications.
The 22 other county jails either do not provide these drugs, do not have policies for how to deal with addicted inmates or did not submit a response to the study, which the Utah Commission on Criminal and Juvenile Justice presented to the state Legislature in mid-November.
“That’s partly a funding issue, a resource issue. … (Not) all of the jails have sufficient resources to get those (drugs),” said Mary Lou Emerson, the director of a substance abuse advisory council tasked with compiling the information the state received from the county jails for the study.
Pilot projects designed to test out different medications in the Salt Lake County Jail have given the facility greater access to these drugs, Emerson said. For other county jails, however, there’s also a concern that narcotic-based medication may prompt illegal activity among inmates.
Yet drugs intended to treat long-term opiate dependence have also given addicts a chance to rewire their brain in a way that can offer hope in a situation often seen as hopeless — most medical studies place the relapse rate for an opioid addict around 96 percent, according to Shelley Andrus, a psychiatric mental health nurse practitioner with Benefis Health System.
Vivitrol, the brand name for extended-release naltrexone, blocks opioid receptors in the brain from becoming activated, meaning that if an addict relapses, they won’t be able to feel the euphoric and pain-relieving properties of opioids.
When asked whether or not implementing these drugs in other Utah jails should be a priority, Kim Cordova, the commission’s executive director, said they would not speculate as to what may be right for each county. Yet, the substance abuse advisory council is expected to put out a list of best practices at the end of November.
County jails that don't offer medication for long-term treatment of opiate dependence may administer other treatments like Valium, codeine, Benadryl, Tylenol, Librium and Gatorade or Powerade for electrolyte replacement, among other things, the report states.
But at least two inmates who died in 2016 were experiencing addiction withdrawals. A woman died in the Weber County Jail of narcotics withdrawal and dehydration, according to the state medical examiner’s report, while another died by suicide after her mother claims the jail withheld her daughter’s anxiety and depression medication.
Both resulted in wrongful death lawsuits.
The report also found that suicide is the leading cause of death in Utah jails, most occurring the day or week of incarceration.
The report was the result of SB205, a bill signed into law in March that requires county jails to report in-custody deaths and alcohol-and-substance-use treatment policies. It seeks to tackle the challenges the state has faced when dealing with opioid addiction among inmates and in-custody deaths.
The council tasked with aggregating the counties’ data is expected to use the information gained to make suggestions for best practices that may inform the 2019 legislative sessions.
Yet, many counties didn’t submit complete information or didn’t have policies regarding medications and treatments for addicted inmates.
“We aggregated what we got and didn’t ask questions,” Emerson said.
The substance abuse advisory council is required to present a similar study each year.
