Assessing Trends In Deaths Associated With Opioid and Alcohol Withdrawal In Jails

This project aims to assess trends in jail inmate deaths 2000-2013 associated with opioid withdrawal and separately, with alcohol withdrawal. Secondary aims examine factors associated with these deaths and compare estimates in deaths from Mortality Files for Jail Deaths in the United States, 2000-2013 with estimates of opioid withdrawal deaths derived from other sources, e.g. legal documents, state reports and press reports. Newly admitted jail inmates have high rates of opioid and alcohol dependence.1 Acute withdrawal from these substances is common in correctional facilities.2 Few jails use FDA-approved medications to manage opioid withdrawal.1,3 Traditionally, opioid withdrawal has been regarded as relatively benign condition akin to “the Flu.” The Federal Bureau of Prison Clinical Practice Guidelines states: “Opiate withdrawal is rarely dangerous except in medically debilitated individuals and pregnant women.”4 The online Medical Textbook, UptoDate states “Unmedicated opioid withdrawal can be quite uncomfortable but rarely life threatening.5 While these assertions about opioid withdrawal may have been historically accurate, there is a dearth of data in the peer reviewed literature regarding current deaths from opioid withdrawal within jails making it difficult to assess their veracity or their current relevance. Our own search of the medical literature has failed uncover any systematic study of deaths in jails from opioid withdrawal. ca/ncf