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?
	Miranda rule and Miranda rights are important The rule, pronounced in Miranda v. Arizona, that confessions are inadmissible in a criminal prosecution if the police do not advise the suspect in custody of certain rights before questioning. The rights include: a. The right to remain silent and to refuse to answer any questions; b. The right to know that anything the suspect says can and will be used against the suspect in a court of law; c. The right to consult with an attorney and to have an attorney present during questioning; d. The right to have counsel appointed at public expense, prior to any questioning if the suspect cannot afford counsel.