Prison becomes detox center for growing number of inmates with addictions
A Westmoreland County Prison inmate experiencing heroin withdrawal last month had to be put in a medically induced coma to stop seizures, according to county officials.
For the next month, deputies rotated shifts around-the-clock at the prisoner's bedside in UPMC Presbyterian, Sheriff Jon Held said.
The number of incoming inmates who need detoxification treatment for drug or alcohol addiction has risen dramatically — 56 percent in two years, said Warden John Walton. Last month, 68 percent of new inmates needed help to be weaned off drugs and/or alcohol, compared with 42 percent in April 2014.
In 2013, an average of 94 inmates addicted to drugs or alcohol were committed to the county prison every month. The monthly average rose to 117 in 2014 and jumped to 147 this year.
In just three months this year — May, June and July — 529 inmates needed detoxification treatment, according to jail records.
“It's just another example of what this drug epidemic is costing the taxpayers of Westmoreland County,” Held said. “Unfortunately, it's going to be worse before it gets better.”
According to the Centers for Disease Control and Prevention, heroin use by young adults has more than doubled in the past decade as the drug became cheaper, more potent and readily available. In turn, prisons and county jails have had an influx of inmates with addictions, experts and local officials said.
“It's an ongoing challenge for corrections systems because they're not equipped to do that,” said criminal justice expert Andrew Harris, a professor at the University of Massachusetts Lowell. “It's awful to be in jail in the first place, and it's not a conducive system for (detoxification).”
Inmates are screened by the prison's medical staff when they arrive, Walton said. Depending on the level of the inmate's addiction and the stage of withdrawal, treatment can range from medication while the prisoner stays in the general population to hospitalization under the watch of sheriff's deputies, he said. Some inmates stay in a medical unit in the jail to be monitored.
“We have not gone a full week this year without an inmate in the hospital,” Held said.
Price of addiction
The impact on medical costs is difficult to measure.
Regis Garris, deputy county controller, said the county does not receive a breakdown of costs from Wexford Health Sources, its prison health services contractor. Westmoreland's five-year contract requires that it pay Wexford a base rate of nearly $9.5 million through 2017, but the actual amount can be adjusted based on the total number of inmates.
The county pays a predetermined amount for health services, but the influx of addicted inmates could impact the cost of new health care contracts, Walton said.
Wexford did not return a call seeking comment Friday.
In 2014, deputies spent 3,320 hours supervising hospitalized prisoners for a number of medical reasons at a cost of $82,379, including overtime. Through Aug. 4, Held said, supervision of inmate hospital patients had exceeded that: 3,359 hours at a cost of $83,446.
“A lot of the issues that they go to the hospital for are results from detox,” Held said.
In Washington County, Sheriff Samuel Romano said his deputies are spending more time dealing with inmates addicted to heroin, whether it's driving them to a methadone clinic or taking them to a hospital.
“We have a hard time doing the rest of our work,” Romano said. “It's not just a Western Pennsylvania thing.”
Warden John Temas of the Washington County jail could not provide figures, but he said the number of prisoners in need of detox treatment has risen in the past few years.
Figures from the Allegheny County Jail were not available.
Heroin withdrawal is akin to “the flu times 50,” with addicts experiencing nausea, cramps and cold sweats, said Tim Phillips, director of Community Prevention Services of Westmoreland County.
“Going through opiate withdrawal is most uncomfortable,” he said.
Becoming what drug users call “dope sick” often is “what often compels people to keep using,” said Dr. Neil Capretto, medical director at Gateway Rehabilitation Center.
With alcohol, withdrawal can be life-threatening if not treated properly, he said.
Couple those symptoms with being incarcerated, and that can make for tough days for the prison staff, Walton said.
“It just makes it more difficult to deal with those types of inmates,” he said.
Most addicts in the Westmoreland lockup are addicted to heroin, prison records show. In July, 67 inmates who needed detox said they were addicted to heroin. Thirteen had prescriptions for Suboxone, which is used to treat opiate addiction.
No end in sight
Substance abuse and crime go hand-in-hand, experts said.
“Most of these people aren't career criminals, but they have to support” their addiction, Capretto said. “There's just more and more of them.”
According to the federal Bureau of Justice Statistics, about 70 percent of inmates in local prisons have committed a drug-related offense or regularly used drugs.
A recent drug bust that netted 100,000 stamp bags of heroin on the Pennsylvania Turnpike believed to be destined for Western Pennsylvania did not affect supply and demand, said county police Detective Tony Marcocci.
“It's actually scary that that does not impact the local trade,” he said.
With no end to the epidemic in sight, taxpayers will continue to foot the bill.
The Westmoreland sheriff's department was granted $156,000 more in July by county commissioners to pay for its added workload. The sheriff hopes that will be enough to make it through 2015.
Renatta Signorini is a staff writer for Trib Total Media. Reach her at firstname.lastname@example.org.