Imagine the worst flu you've had, multiplied by 10.
That's what addicts say withdrawals from opiates are like, said Mark Kemmet, behavioral health specialist at the Burleigh-Morton County Detention Center, speaking to a room of county officials Tuesday morning at a North Dakota Association of Counties session on jails and justice reform.
"The social detox level of care is a gap and key area of need in our state," said Dr. Lisa Peterson, clinical director for the state Department of Corrections and Rehabilitation.
Withdrawal management and suicide prevention are two focus points of care, according to Peterson. Withdrawals from opiates can be fatal due to dehydration, while suicidal potential can be a difficult risk to assess.
The DOCR's last completed suicide was about a year ago, when a 22-year-old man was found dead after learning his probation had been revoked, bringing more prison time, Peterson said.
"That's a scary situation," she said. "It's not so much how we label the behavior but how we respond to it."
Kemmet said his work largely involves accessing services.
"What I'm doing is not treatment per se, but assessment and getting people referred to services," he said.
Questionnaires and screening help determine who may need help, from housing to mental health to winter clothes.
Jail inmates have requested alcohol and drug counseling, Kemmet said, but that service isn't available at the holding facility, according to Kemmet, who said programs at the Burleigh-Morton County Detention Center are limited.
However, the jail has worked in conjunction with the Heartview Foundation in developing a screening process via a federal grant, he said.
"A lot of what we're doing is trying to get things implemented to slow down the revolving door process," Kemmet said, also lauding medication-assisted treatment that Heartview and Community Medical Services have cross-trained on.
Peterson also addressed efforts stemming from the state's $7 million justice reinvestment to develop a continuum of care rather than hard beds, she said.
Some county officials voiced what they've perceived as tension between the DOCR and counties, particularly regarding funds and resources.
Cass County Sheriff Paul Laney called the tension "the elephant in the room" in regard to some dynamics of state vs. county corrections.
Cass County Commissioner Chad Peterson talked about the county utilizing beds in Clay County in Minnesota and Grafton facilities for inmates who need help.
"I can't keep them in jail long enough to make them better," he said.
Laney, Chad Peterson and Lisa Peterson said they welcome collaboration among state and county agencies to get on the same page regarding treatment and resources.
After the meeting, Lisa Peterson said the tension likely stems from some perceptions of SB 2015, passed last legislative session in regard to prison population management and operating capacity.
"I'm hoping we move forward and address this as a state," she said of the justice reforms.
Before the session's end, an open invitation was issued for an interim legislative committee meeting at 9 a.m. Oct. 24 in Grafton to discuss evaluating the Life Skills and Transition Center there.