Traverse City Record-Eagle

January 27, 2013

Lockup detox: today's dilemma

BY GLENN PUIT
gpuit@record-eagle.com

TRAVERSE CITY — Randy Woodcock takes prescribed methadone and morphine every day.

But in 2010, after his arrest on a methadone-related charge in Grand Traverse County, Woodcock said he was denied methadone while housed at the county jail.

He contends the withdrawal nearly killed him. He spoke out about his experience in the hope it will foster awareness about withdrawing from methadone, cold-turkey, while in custody.

"I was sweating bad," Woodcock said. "They wanted me to bring my (prescriptions), but you are in there. So what do you do?"

Law enforcement officials dispute Woodcock's account. Undersheriff Nathan Alger said Woodcock was given methadone while housed one night at the jail, and that the jail has an extensive policy in place to make sure inmates who need prescribed medications get them.

"The end goal, in the long run, is we want the inmate to not have any medical issues inside our facility," Alger said. "We want them to be safe and sound."

Woodcock, 56, of Bay City, was arrested after authorities said he gave another man methadone. He pleaded guilty to a reduced charge of drug possession. He has prescriptions for methadone and morphine for chronic pain because of multiple back surgeries and a fall.

Woodcock contends the allegation that he dealt methadone made authorities skeptical that he needed the drug after his booking into the jail.

"They didn't give me any," Woodcock said. "They told me I was selling them, so I wasn't taking them."

Woodcock said he went into withdrawal, and nurses eventually advised that he needed methadone.

"I felt I was dying," Woodcock said. "I went through a whole roll of toilet paper, I was sweating so bad."

Medical staff makes the call

Jail officials maintain Woodcock's case was handled properly and that he ultimately received methadone. Alger said the jail always defers decisions about medications to medical staffers and a doctor, if necessary, to make sure inmates don't have health problems.

"They have the ability to prescribe some medications to alleviate symptoms of detox," Alger said.

Jailers throughout the region said they struggle with the same issue on an almost daily basis: what to do about inmates who are dependent on powerful narcotics like methadone, heroin, Oxycontin and other prescription drugs.

"When the inmate comes in, you defer it to medical staff," said Sgt. Todd Rawling, who serves as jail administrator in Antrim County. "We are not doctors and we are not nurses. We observe and ask questions ... and you handle each on a case-by-case situation. Most jails do not want narcotics in the jail for numerous reasons."

One recent federal drug use survey shows usage of opiate-based drugs doubled between 2000 and 2011. In 2011, the White House called Americans' abuse of prescription drugs an "epidemic."

Jeff Conquest, a lieutenant at the Benzie County jail, said roughly 75 percent of the inmates who come into that facility end up there because of drug or alcohol abuse, and many face significant detox challenges.

"It is an issue; we do a medical screening," Conquest said, adding "we are always concerned about (inmates') drug levels and alcohol levels. If someone is 0.3 or above alcohol level, they go to the hospital."

Jails across the country face litigation tied to inmates and their withdrawal from drugs.

In Longview, Texas, in 2010, a 33-year-old woman died while in custody at a county jail. She was receiving treatment at a methadone clinic at the time of her arrest, and an autopsy listed the cause of death as seizure caused by withdrawal from methadone and prescription drugs. A civil lawsuit on her behalf was settled last week.

In Kalamazoo, county officials were sued in August 2012 on behalf of an inmate who died a year earlier at the county jail during withdrawals from heroin. The family of Andrea Armstead said she should have received better medical care because she told jailers she was addicted to heroin.

In Orange, Fla., two inmate deaths in 1997 and 2001 were tied to methadone withdrawals, prompting jail officials to begin dispensing methadone to addicted inmates.

Local man died in jail

Closer to home, inmate Danny Whitney Jr. died at the Grand Traverse County jail in March 2012 from a methadone overdose. That incident involved drugs Whitney ingested before he was taken into custody.

Family members said jail officials should have placed Whitney under closer observation, but jailers said Whitney misled them about the amount of drugs he'd ingested.

Alger said the jail has a comprehensive medication dissemination program, and the policy is carried out to protect inmates' well-being.

"When someone comes in and has medication prescribed to them, they are provided that medication until (medical staff) makes a determination if it's a valid medication and if it's to be continued," Alger said.

"They are assessed by medical providers at the jail who sit down and review the prescription, review underlying causes, and determine whether that medication needs to be continued inside the facility," Alger said. "Normally, if it is a legitimate prescription, it is."

The dispersal of methadone and other powerful drugs also takes into consideration the need to prevent inmates from circulating drugs among other inmates, Alger said.

Withdrawal from methadone often involves significant flu-like symptoms, and it can be fatal.

"Dependence is a natural consequence of taking opioids," said Terry Baumann, a clinical pharmacy manager at Munson Medical Center. "After taking them for a while, if you abruptly stop taking them, you will experience withdrawal symptoms."

There are different treatment options for weaning methadone users from the drug, Baumann said, including a gradual decrease in dosage over time.

For Woodcock, the experience left him questioning how many others face cold-turkey withdrawal from drugs at northern Michigan jails.

"I don't think it's right," Woodcock said, adding "how many more others are there?"