by Christopher Zoukis

There is a growing epidemic of opioid addiction in the United States. According to the federal Centers for Disease Control, over 33,000 opioid-related deaths occurred in 2015, representing a quadrupling of such fatalities since 1999. It is estimated that three-quarters of crimes are related to drugs and two-thirds of prisoners have a history of substance abuse.

People who end up in jail are increasingly users of heroin, painkillers and methadone. And while the offenses for which they were arrested are frequently minor, the punishment they receive sometimes amounts to a death sentence. This focus on opioid-related deaths is a more specific aspect of the larger problem of people dying in jails due to inadequate healthcare in general. [See: PLN, Jan. 2017, p.44].

PLN reviewed details surrounding the deaths of ten opioid addicts in county jails across the United States. All were preventable. Had their addictions been treated as a medical issue and not as part of the criminal justice system, their deaths could have been avoided.

Jennifer Lobato, 37, was booked into the Jefferson County jail in Colorado in March 2015 for shoplifting $57 worth of merchandise from an Old Navy store. She vomited, collapsed and died while a guard scoffed at her. [See: PLN, Nov. 2015, p.63]. Lobato left behind seven children; her estate sued the county, which settled for $2.5 million in November 2016.

Kevin Fiscella, an addiction specialist who sits on the board of the National Commission on Correctional Health Care, compared the mistreatment and ultimate deaths of addicts in local jails to a nefarious research study.

“What’s happening in jails, it’s kind of a natural experiment to see what happens,” he said. “And in fact some people do die.”

Fiscella placed the blame partly on the lack of proper staffing levels in the health care units at many facilities.

“In a lot of these deaths, people were simply ignored,” he stated.

Tyler Tabor was another parent, a 25-year-old with a young son, when he was arrested in May 2015 for two misdemeanors. Three days after being booked into the jail in Adams County, Colorado, he was dead. [See: PLN, Sept. 2017, p.32; Nov. 2016, p.63].

Tabor died from dehydration related to opioid withdrawal. According to a lawsuit filed against the county and Corizon Health, the jail’s private health care provider, Tabor suffered from vomiting, diarrhea and low blood pressure in the days leading up to his death. He was eventually unable to stand or walk, and begged for an IV. Told that IVs were only used when “absolutely necessary,” he died six hours after requesting one – leaving behind his parents, a wife and a 5-year-old son.

Tabor’s father, Ray Tabor, lamented the manner of his son’s death.

“It’s one thing to lose a child,” he said. “But it’s another thing knowing that he died in a jail cell alone on the floor, asking for help.”

Nicole Carmen, 39, was booked into jail in Schenectady County, New York for a parole violation in April 2013. She died after four days in a coma following a harrowing day in which she suffered a stroke, aneurism and a lung infection, based on court documents.

According to a complaint filed by Carmen’s estate in federal court, by her third day in jail “the walls and floors of Ms. Carmen’s cell were [] covered with vomit, bile and feces.... Ms. Carmen was also observed as incoherent, and exhibiting jerking motions on the left side of her body, indicative of seizure activity.” She was taken to the infirmary, but sent away because the head nurse decided that she was “faking it.” Carmen died a short time later.

Her estate settled the wrongful death suit for $425,000 in December 2015. According to attorneys representing the estate, the private health care provider at the jail, Correctional Medical Care (CMC), had a profit motive in ignoring prisoners’ medical needs. [See: PLN, Jan. 2017, p.39; Sept. 2016, p.54].

“Every dollar that CMC spends providing care to inmates directly affects their profit margin, providing a direct incentive to provide inadequate medical care to inmates,” the attorneys said.

Lindsay Kronberger was 24 when she was booked into the Snohomish County, Washington jail in January 2014 for “suspicion of violating a court order.” She arrived at the jail weighing 95 pounds, and nurses noted she had a high heart rate and low blood pressure.

Kronberger asked to be taken to a hospital but her request was refused. She spent the last days of her life being dragged from one vomit-filled cell to another because she could not stand or walk. According to a lawsuit filed by Kronberger’s estate, video surveillance showed a jail guard mocking her as she lay dying.

“Lindsay was medically fragile, vulnerable, and completely under their power and control,” said Karen Moore, the attorney representing Kronberger’s family. “They stood just outside her cell mimicking and mocking her as she lay on her bed suffering needlessly.”

Kronberger eventually died on the floor of her jail cell. The inhumane attitude displayed by jail officials in Kronberger’s case is not uncommon in county jails.

After 18-year-old Tori Herr died in April 2015 while detoxing from heroin at the jail in Lebanon County, Pennsylvania, an unnamed guard from the facility posted an atrocious comment on Herr’s Facebook tribute page:

“I find this so funny that people want the tax payers to pay for people going through withdraw (sic) in prisons.... So, I say let them do there (sic) ‘hard’ withdraw (sic) and spend the money on someone that is gonna appreciate it!!!! You do the crime, it is up to you to do the time!!!!”

Stephanie Moyer, Herr’s mother, filed suit against the facility, the warden, medical staff and jail guards in July 2016 over the wrongful death of her teenage daughter. Commenting on the lawsuit, Moyer pointed out the unique position of jailers when it comes to providing care for opioid addicts.

“The correctional system is really in a good spot to help people, to help give them the ability to return safely to the community and have goals,” she said. “They have a job that can yield great blessings, if they do their job properly.”

Jail and prison officials have choices when it comes to dealing with opioid addicts in their facilities. Cold turkey detox can lead to death, and research has shown that maintenance treatments such as methadone and Suboxone reduce relapse and overdoses.

“I’m not going to bring those drugs into the facility,” said Warden Brian S. Miller of Fayette County, Pennsylvania. “If you were a gambler and you were in the casino every day of the week ... and I locked you in a room and gave you scratch-off tickets, how’s that helping?”

Miller’s ignorance of the physical reality of opioid addiction underscores why so many corrections officials refuse to properly treat addicts, which in some cases results in their deaths.

“The whole idea of detox is a flawed one,” said Dr. Josiah D. Rich, a professor at Brown University and director of the Center for Prisoner Health and Human Rights. The idea that jailers “just stop you from taking this medication for a period of time and then put you back into your same environment and expect you to be cured, is absurd.”

The missed opportunity to positively intervene in an addict’s life also has a social cost, reflected in the crimes committed by those who survive jail but lapse into recidivism to support an untreated drug habit. The much larger waste, however, is the lives that are lost in jails that refuse to recognize and treat opioid withdrawal.

David Stojcevski, a 32-year-old opioid addict, was booked into the Macomb County, Michigan jail in June 2014 for failure to pay a $772 fine for careless driving. His sentence amounted to 16 days of uncontrolled vomiting and diarrhea, a loss of 50 pounds and ultimately death. [See: PLN, Jan. 2017, p.28; Mar. 2016, p.63].

According to Jim Cheney, a representative for the Macomb County jail’s medical contractor, Correct Care Solutions, the company’s withdrawal protocol is “one of the most advanced and respected in the industry.”

Madeline Pitkin, a 26-year-old addict, was arrested and booked into jail in Washington County, Oregon on a traffic violation in April 2014. She died after seven days of begging for medical help while suffering through cold-turkey opioid detox. Faced with a $20 million lawsuit, the county ended its contract with jail medical provider Corizon Health – and threw the company under the bus.

“During normal administrative review of medical records in the days following Ms. Pitkin’s death, the sheriff was shocked and dismayed to learn of Corizon’s apparent lack of response to her written requests for medical help,” read the county’s official statement. “Accordingly the sheriff asked the district attorney to assign the County’s major crimes team to conduct a criminal investigation of Ms. Pitkin’s death.”

Madison Bailee Deal, a 26-year-old addict, was arrested for violating probation and theft under $500 in August 2016. She was booked into the Silverdale Detention Facility, operated by CoreCivic – formerly Corrections Corporation of America – in Chattanooga, Tennessee. She reportedly died due to pneumonia after inhaling vomit while going through withdrawal. [See: PLN, Jan. 2017, p.63].

Deal’s family has filed suit against the facility, alleging that she made frequent requests for help but was ignored. She even asked her mother to get her transferred to a hospital, without success.

“The Silverdale personnel just ignored her pleas, and ignored the pleas of the other inmates to get her help,” said family attorney Tom O’Neal.

Marion Herrara, 40, was booked into the Weber County jail in Ogden, Utah in May 2016 after allegedly cashing a forged $763 check at a credit union. She died less than four days later of dehydration while undergoing heroin withdrawal.

Though she was moved to a medical unit for detox treatment and liquid diet restrictions that should have been monitored, the jail did not offer any medication to ease her withdrawal symptoms. And despite the fact that jail officials were instructed to observe her “hydration status,” her body was found in a cell with a cup of liquid merely placed in a port on the door – where it remained untouched.

According to a federal lawsuit filed by Herrara’s husband in September 2017, jail personnel “exhibited a shocking degree of deliberate indifference and reckless disregard for [her] evident medical needs.”

Sheriff’s Department spokesman Lt. Nathan Hutchison said jail staff gave Herrara “the best treatment they could,” but noted she was a member of a group of “people whose health has never been a priority.”

Audrey G. “Jenny” Fulton, 27, was arrested in October 2014 after testing positive for substance use while on probation. She was booked into the Mason County Detention Center in Kentucky. According to a lawsuit filed by her mother, Fulton spent the next three days begging from the floor of her cell to be taken to a hospital because she felt like she was dying. In fact she was suffering from severe dehydration as a result of uncontrollable diarrhea and vomiting caused by heroin withdrawal, which was complicated by Crohn’s Disease.

She died on October 31, 2014 and her family filed a wrongful death suit the following year. The county agreed to settle the case in May 2017 for $750,000. See: Fulton v. Macon County, U.S.D.C. (E.D. Ky.), Case No. 2:15-cv-00031-WOB-JGW.

Deaths of opioid addicts in county jails are often preventable with proper treatment, according to Fiscella, the addiction specialist. But, he added, it is virtually unheard of to withdraw from opioids without slowly tapering off or receiving emergency medical care.

For a “Frontline” broadcast in August 2017, PBS spent a year following 10 recovering addicts – including Dave Mason, 43. The homeless man had left a correctional facility in New Haven, Connecticut for the fourteenth time in October 2014, just two weeks clean from a heroin addiction. Statistics would not offer much hope for his chances, but he has endured and in fact improved, thanks to a methadone treatment program offered by the state.

“It is the key to my success,” Mason said. “It did what it was supposed to do. It kept me clean.”

Sadly, the same cannot be said for prisoners who suffer preventable deaths in local jails due to the failure of corrections officials to properly treat their opioid addictions and withdrawal symptoms. 

Sources: www.motherjones.com, www.timesunion.com, www.mycolumbiabasin.com, www.themarshallproject.org, www.timesfreepress.com, www.seattlepi.com, www.post-gazette.com, www.readingeagle.com, www.9news.com, www.ktvz.com, www.denverpost.com, www.clickondetroit.com, www.freep.com, www.standard.net, www.correctionsone.com, www.kentucky.com, The New York Times, www.cdc.gov

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