Henry Weaver’s girlfriend is in the Durham County jail. She had been addicted to heroin and about six months ago began methadone maintenance treatment. According to Weaver, since starting methadone maintenance she had not one relapse and was doing well – slowly starting to put her life together.
Recently she was incarcerated in the Durham County jail, which does not give methadone maintenance treatment. Without her methadone maintenance, she began going through withdrawal. Weaver says that she is so sick from withdrawal, she cannot eat, and is suffering. Furthermore, Weaver is afraid that the disruption of her treatment may jeopardize her recovery after her release.
Correct Care Solutions, the company Durham County contracts with for medical services in the jail, has been the subject of multiple lawsuits concerning the suffering and deaths of people who use opioids and benzodiazapines, including one recent death in North Carolina in the Forsyth County jail, one in Detroit and one in Denver, Colorado.
Dangerous withdrawals are not the only life-threatening situation that people who use drugs face during incarceration. Recently, community members have brought to light deaths in the Durham County jail. One man who died was Dennis McMurray, whose autopsy report indicated that the cause of death was an overdose by fentanyl, an opioid. The coroner’s report indicated that McMurray informed the Durham Jail medical staff that he had consumed heroin before he overdosed and died.
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Almost all heroin in North Carolina is cut with fentanyl, and both drugs are opioids. If it is known that an individual has ingested an opioid, the moment he starts to show symptoms of overdose, such as nausea and shortness of breath, which McMurray reported, naloxone should be administered. Naloxone (also known as Narcan) is the only drug that can reverse an opioid overdose. Naloxone has no negative side effects on people who are not experiencing an overdose. In fact, it is so safe that in North Carolina, if you suspect someone is overdosing on an opioid, it is legal for bystanders to administer naloxone.
Yet the autopsy reports that in the 13 hours after McMurray’s arrest, the medical staff attempted to provide him only with anti-nausea medication. McMurray’s death was entirely preventable.
Both of these tragedies – Henry Weaver’s story of his girlfriend’s painful withdrawal inside the jail and Dennis McMurray’s tragically preventable overdose – should lead us to ask tough questions about what we as a society are doing to address addiction and the negative consequences of drug use. The recent growth of opioid use has been labeled as a national public health crisis. The American Medical Association views addiction as a chronic disease, like any other, that improves with treatment. Research has indicated that addiction is very likely a result of people medicating themselves for trauma they’ve experienced. From either of these perspectives, people experiencing substance-use disorders need support, not punishment.
But here in Durham, that’s not how it works. When people who use substances are arrested, they are not taken to Durham Access for treatment, as County Commissioner Ellen Reckhow reported at the Jan. 11 commissioners meeting, they are taken to jail. And while the Durham Jail has the STARR program (an addiction recovery program in which very few inmates can participate), it still forces those on proven treatments for addiction, such as methadone maintenance therapy, to stop and suffer withdrawal. Further, it appears that the jail was incapable of acting to save the life of a person in its custody experiencing an overdose.
What else can we expect from the drug war and the new era of mass incarceration? These things are fundamentally opposed to a humane view of substances users, and so long as we meet substance use with incarceration, the suffering and death will continue. These are reasons to support an independent investigation of the Durham County jail, but that is not enough. Outside the jail we often hear from people that it is like a machine, that it eats up people with problems, reproduces their troubles, then spits them back out to restart the cycle. We need to stop the machine.
Stephanie Gans is working on a master’s degree in social work at UNC-Chapel Hill. David Theurer is a nurse at Duke University Hospital.