When it comes to managing substance use disorders in jails, there are many moving parts and parties involved.
Challenges stemming from inmates with withdrawals after detox and reduced tolerance upon their sober release have emerged in recent years, particularly in the current opioid epidemic. Training available from recent federal funding has kickstarted state assistance for jails to better manage treatment and resources for those afflicted with a substance use disorder. On Wednesday and Thursday, staff from North Dakota jail and corrections entities met in Fargo and Bismarck to discuss addiction treatment moving forward.
The Heartview Foundation and Community Medical Services contracted with the North Dakota Department of Human Services for correctional training and technical assistance, working with jails to help develop policies at this early stage.
"You have to have those policies and implement those policies and see them to fruition," said Pamela Sagness, director of the NDDHS behavioral health division.
She also said that assessments at the time of an inmate's admission are not effective enough. Intoxicated individuals can develop withdrawals. Some people may not have medication like suboxone or methadone with them when admitted to jail, she added.
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"We need to make sure we educate jail administrators from corrections staff to officers," Sagness said.
Meanwhile, opioid use on the rise has challenged practices in pain management, said Dr. Lisa Peterson, clinical director for the state department of corrections and rehabilitation. Most users don't start with heroin, she said. Use can even stem from drugs for wisdom teeth removal.
"We definitely see opioid use on the rise and along with that comes overdoses and deaths related to that," she said. "(Addicted) folks coming into our facilities are really at risk in a couple of ways."
Inmates with addiction are at high risk for withdrawals, which can create serious conditions, Peterson said. Also, upon release, inmates can lose tolerance against a drug after sober incarceration. Some people have a predisposition in their brain chemistry to respond negatively as well, she said.
Moving forward, Sagness said medical staff and law enforcement will integrate into training as parts of the equation to better treatment. Thursday's event in Bismarck largely involved jail administrators and their medical and mental health staff, she said.
"It's so important that we recognize law enforcement and medical providers as part of the solution," she said.
Capt. Lisa Wicks, of the Burleigh-Morton County Detention Center, said three staff members attended Thursday's event, including Maj. Steve Hall, behavioral health specialist Mark Kemmet and nurse Tara Canright.
Reach Jack Dura at 701-250-8225 or firstname.lastname@example.org.