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Opioid Epidemic Keeps Climbing at California Prisons, and Claiming Lives of Released Prisoners as Well

With opioid overdoses claiming the lives of over 68,000 Americans annually, detention facilities have reported a corresponding rise in drug-related deaths among those incarcerated or recently released. (See PLN, September 2019, p. 1.) California’s nearly three dozen penal institutions recorded 997 overdoses in 2018, more than double the number just three years earlier. Forty prisoners died from overdoses in California in 2017, a rate three times the average nationwide.

Although cancer, heart disease and liver disease remain the top killers of California prisoners, overdoses have outpaced suicides and homicides since 2017 to claim the fourth spot. Meanwhile, a November 21, 2019 story in Capital & Main said that “Drug overdoses are the single greatest factor contributing to Los Angeles’ rising rate of homeless mortality,” and that many of those dying on the streets were recently released prisoners. “Released prisoners may get clean behind bars…but the medications prescribed in jail detox programs aren’t normally the kind to adequately wean them from their opioid cravings,” the story said. “With the resultant loss of tolerance, if they relapse on the outside one erroneously judged dose can kill them.”

The numbers of prison deaths have risen despite increases in funds to fight the influx of drugs into the state’s lockups. Under a 2018 plan spearheaded by former Gov. Jerry Brown, $13.8 million was spent in California Department of Corrections and Rehabilitation (CDCR) facilities on body scanners, urine tests, drug-sniffing dogs and camera surveillance, yet these added security measures have made little impact.

The former finance chairman of the guards’ union, Joe Baumann, blamed loopholes in the process. The scanners do not detect drugs smuggled inside orifices, which he said visitors could remove in a bathroom and then pass to prisoners. Other smugglers filled tennis balls with contraband substances and threw them over the penitentiary fences. Although visits are limited to weekends, employees have access to prisoners at all times, and Baumann admitted that occasionally ‘‘dirty” guards had facilitated smuggling operations. Corrupt staff are the main conduits, in terms of sheer bulk, of drugs introduced into detention facilities yet they are subjected to fewer searches or countermeasures, which allows the problem to continue.

“There are so many opportunities, so much money to be made, I don’t think there’s one single answer,” agreed Jody Lewen, who established the Prison University Project to offer higher education at San Quentin State Prison. “As long as there are human beings going in and out, there are going to be opportunities.”

The National Institute on Drug Abuse estimates that two-thirds of the U.S.’s 2.3 million prisoners suffer an addiction to drugs or alcohol. But most of the country’s lockups – about 2,000 state and federal prisons and 3,100 county and municipal jails – do not provide any of the three drugs used in Medically Assisted Treatment (MAT), despite approval from the federal Food and Drug Administration. Only 120 jails in 32 states as well as just 10 state prison systems offer even one of the three MAT medications: methadone, buprenorphine or Vivitrol.

While some politicians believe imprisonment forces addicts to abandon their drug use, addiction physician R. Corey Waller says that “prisons aren’t the sterile environment people think they are.”

“The pressures to use drugs inside are even greater than they are outside,” he added. “On the outside, you can escape pressures, go to your aunt’s house or something. But when you’re in a jail or prison, if you try to ignore the inmate in your yard who wants to sell you drugs, you’re at risk for physical harm.”

The problem continues at least two years after release, when former prisoners face a risk of death triple that of the general population. In just the first two weeks, the risk of a fatal overdose is 13 times higher.

That’s why Rhode Island Gov. Gina Raimondo led the state in 2016 to begin providing all three drugs for MAT to every one of its state prisoners with an opioid addiction. Along with addiction counseling, the one-of-a-kind, $2-million-a-year program – which includes follow-up treatment after a prisoner is released – has cut overdose deaths after release by two-thirds, from 26 to just nine in its first full year. Some critics question whether substituting one drug for another really solves the problem or merely prolongs it.

“Half my friends are in graveyards,” said 58-year-old former Rhode Island prisoner Lloyd Baker, “because when they got out of prison, they used what they did before they got in – and now they’re gone. I was one of the lucky ones.”

In May 2019, California Gov. Gavin Newsom introduced a plan to provide treatment at most of CDCR’s correctional facilities to prisoners struggling with addiction. With an estimated two-year cost of $233 million, the plan would be the nation’s largest.

“The value of this goes way beyond prisons,” emphasized Dr. Matt Willis, public health officer in Marin County, where San Quentin State Prison is located. “This will save lives and money.”

County emergency medical crews responded to four fatal overdoses of fentanyl on San Quentin’s Death Row between November 2017 and December 2018. The death of a fifth condemned prisoner in June 2019 was also attributed to a heroin overdose.

A rise in popularity of fentanyl – a synthetic opioid that can be 100 times more powerful than morphine – is a factor in California’s burgeoning prisoner overdoses. Because of its potency, an effective dose requires a very small amount of the drug, making it easier to smuggle. In April 2018, at least a dozen men at Mule Creek State Prison overdosed on fentanyl during a single weekend. One of them died.

Newsom’s plan, like the one in Rhode Island, includes substance abuse treatment for prisoners facing release to help them remain in recovery after they leave prison.

“The way to interrupt the cycle of addiction and crime that lands people in court over and over again is to treat the addiction,” Dr. Willis said. Another way is to decriminalize drugs and treat it as a public health problem the same way that smoking and alcoholism are treated. 


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