Many jails in Oklahoma are ignoring a state law requiring jail physicians to provide treatment to prevent inmates from undergoing methadone and opiate withdrawal during their incarceration.
President of the Oklahoma Association for the Treatment of Opioid Dependence Ann Jamieson has been connecting with jails, treatment programs and doctors to help spur implementation of Senate Bill 854, which was passed by the Oklahoma legislature and signed into law by Gov. Mary Fallin in May 2011.
The law states jail physicians must be particularly aware of the impact of opiate or methadone withdrawal symptoms which could affect the mental and physical health of the prisoner. They must then prescribe and administer appropriate medications.
Methadone is a synthetic opiate narcotic that when used once per 24 hours, orally, in adequate doses, can normally suppress an opiate addict’s craving and withdrawal for one day.
In a few counties, said Jamieson, inmates are being escorted to treatment facilities for medication — something which was extremely rare prior to SB 854. One county has an officer visit the program facility to pick up the methadone.
Jails aren’t treating withdrawal
After polling representatives of the 14 opioid programs in the state, Jamieson said most reported the jails in their counties continue to refuse to do anything to treat methadone withdrawals for the inmates despite the law requiring they do so. Jamieson said she was not free to release the names of these counties.
“Most counties in Oklahoma are allowing opiate dependent prisoners to suffer withdrawal in jail,” she said.
Payne County Jail Administrator Reese Lane said the jail has not had to make any changes in policy to comply with the law. Lane said some inmates have been prescribed and treated with methadone in jail, but it is rare. Lane said there is a nurse at the jail 80 hours a week and a mental health professional at the facility four hours a week. A physician visits the jail at least once a week but physicians are on call 24 hours a day.
The bill was initiated by State Sen. Jim Halligan, R-Stillwater, after a Payne County resident brought the issue of methadone and opiate withdrawal to his attention.
“I thought it would be appropriate for us to try and incorporate into law that when someone is incarcerated we need to be mindful of their needs — particularly with respect to drug problems,” Halligan said.
The resident was Ron DuBois. His son, Peter DuBois, died in 2010 after falling approximately 12 feet in the Payne County Jail where he was an inmate. The cause of death was determined a suicide. Peter was chemically dependent on methadone, his father said.
“There is a profound misconception about opiate dependence and withdrawals,” Jamieson said.
Methadone a sound treatment option
Jamieson has been in the field of opiate and methadone dependence for 16 years and has often encountered professionals who have negative views toward methadone treatment. She said using methadone to treat opiate dependence is the best course of action for severe opiate addicts.
Long-term opiate use changes the way nerve cells in the brain work to the point in which they become overstimulated and need an opiate to function. If opiates are taken away from dependent nerve cells, many cells become overactive, causing severe withdrawal symptoms.
This is why patients are given methadone, Jamieson said. The patients no longer have to use illicit drugs that cause dangerous impairment, intoxication and withdrawal.
Methadone patients are as physically addicted to methadone as other opiates, like oxycontin or vicodin. Withdrawal symptoms are slightly less severe than those from heroin or morphine but can last for weeks.
At high maintenance doses, sudden cessation of therapy can result in methadone withdrawal symptoms described as the worst withdrawal imaginable, Jamieson said.
“They can have a life free of the horrors of opiate use,” Jamieson said. “Methadone stabilizes withdrawal and allows an addict to work, take care of their families and live a normal life.”
Jamieson said she hopes the law will eventually be fully implemented to create fair treatment for methadone patients.
“All people deserve to be treated with dignity and respect, and we will continue to fight for the rights of these patients who are suffering from a horrible disease,” Jamieson said.