Criminal Defense News

Management Of Opiate Detoxification In Jails

A 2002 national survey of 500 U.S. jails included a question about the assessment and management of opiate dependency among arrestees and inmates, as well as the use of standardized protocols. 

Of the 245 jails that responded to the survey, 56 percent reported that they routinely assessed arrestees for opiate dependency, and 59 percent stated they used standardized detoxification protocols; 50 percent of the jails used clonidine for detoxification. Only 1 percent of the jails used methadone or other opiates (2 percent) for detoxification. Forty-nine percent of the jails did not use clonidine, methadone, or other opiates for detoxification. Although several small randomized controlled trials suggest that the use of clonidine for opiate detoxification is associated with comparable rates of detoxification, these findings may have limited generalizability. Other studies suggest that the use of clonidine outside of jails is associated with significant attrition and greater severity of withdrawal symptoms than when opiates such as methadone or buprenorphine are used.

The apparent failure of more than one-third of the jails to provide detained, opiate-dependent persons with care consistent with community standards makes them vulnerable to litigation regarding inmates' right to health care and humane treatment. Many opiate-dependent detainees can experience withdrawal symptoms before they have been formally charged with a crime. Lacking appropriate detoxification, opiate-dependent detainees may experience needless suffering and, in some instances, death. These findings indicate the need for uniform, national standards for the management of opiate dependence in U.S. jails. 3 tables and 27 references

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	Did You Know?
	There are 3 basic types with standard of proof There are essentially three standards of proof applicable in most court proceedings. In criminal and delinquency cases, the offense must be proven beyond a reasonable doubt, the highest standard. In civil cases and neglect and dependency proceedings, the lowest standard applies by a mere preponderance of the evidence (more likely than not). In some civil cases, and in juvenile proceedings such a permanent termination of parental rights, an intermediate standard applies: proof by clear and convincing evidence.