I'm a new grad from a practical nursing program but the amount of information that I don't know far surpasses what I do.
Sadly, my little sister (23) is currently detoxing at a local correctional facility. (IV heroin and anything else she can get) I've refused to bail her out in fear that she will end up dying if she doesn't get help.
To make a long story short, I'm wondering what the chances are that she'll get any help while in there? Even just symptom management..... I just read some horror stories of people dying from withdrawals while incarcerated.....
It's been about 48 hours since she was arrested and shes telling my parents shes getting no treatment. Unfortunately, there is never any way of knowing if she is being truthful.
I am suddenly sick thinking that she could be suffering without so much as Imodium to help get her through. Mind you, I know some suffering is to be expected and even necessary, but...... I remember the day she was born, I can't handle thinking the worst....
Any info would be greatly appreciated. I think I am going to try to have her involuntarily committed to a rehab facility, but it will be weeks before she's transferred if it even works.
Sorry to be all over the place, I've been a member of AN for a long time, but I rarely make my own threads. Just really need some information for my own sanity.....
I think I am going to try to have her involuntarily committed to a rehab facility, but it will be weeks before she's transferred if it even works.
It doesn't work that way.
Chemical dependency is not cause to deny someone their civil rights. While acutely intoxicated, she can be held against her will. If she is deemed an imminent and present danger to herself (that is, gravely disabled or suicidal), she can be held against her will. But simply being in the throes of drug addiction? Not in any jurisdiction of which I'm aware.
And the truth is, it wouldn't work. The only means to sustained recovery from chemical dependency is via a personal decision to do the lifelong hard work of recovery... hitting the so-called "rock bottom" from AA.
I've been down this road with loved ones before, now would be a good time to practice your boundaries. The little baby you love is still there, but she is in the deadly grip of a potentially fatal disease. The caring heart that probably guided you to nursing may be used against you by her illness (I find it easier to separate the loved one from the awful disease).
The involuntary commitment is allowed in my state, but only after two doctors deem her to be chemically dependent and a danger to herself. Although I know it usually doesn't work, I was hoping to get her help before I start planning her funeral. I have no qualms about taking away her civil rights if it means she'll get the help she needs.
Thanks all for the info, I was worried about her getting zero help in there and wasn't totally sure if heroin had any additional withdrawal effects since it's mixed with god knows what.
Looks like my parents are coming to get her (they live 1,000 miles away) and she's agreed to go to rehab. I've told them her word means nothing at this point, but they won't listen.
Thanks again, everyone. It means a lot that you're all so kind.
Chemical dependency is not cause to deny someone their civil rights. While acutely intoxicated, she can be held against her will. If she is deemed an imminent and present danger to herself (that is, gravely disabled or suicidal), she can be held against her will. But simply being in the throes of drug addiction? Not in any jurisdiction of which I'm aware.
And the truth is, it wouldn't work. The only means to sustained recovery from chemical dependency is via a personal decision to do the lifelong hard work of recovery... hitting the so-called "rock bottom" from AA.
You simply cannot force somebody into sobriety.
In my state, it's possible. She would go to a court ordered rehab for 30-90 days. My feeling is that if she can at least get clean long enough to consciously make the choice to refuse help at least I can say I tried. I know it probably won't work, but I won't be able to live with myself if she ODs and I never tried it.
I worked corrections, albeit prison and not jail. In my prison, opiate users don't get any special treatment for detox except for perhaps an infirmary stay for a couple days through the worst of it. The first 2-3 days (in my experience) are the hardest, but the withdrawal symptoms do last for 7-14 days.
If she was one of the very very very very few that seizes or has other issues from opiate withdrawal (usually caused by them also being benzo addicted and not bothering to tell us, not actually from opiates), she would be transferred to a hospital.
People die from benzo withdrawal and alcohol withdrawal. An opiate user will feel like they got hit with a six ton bag of bricks, food poisoning, and swine flu all at the same time, but they won't die from it. That's why most states/most hospitals do not consider opiate withdrawal an appropriate admitting diagnosis unless there are obvious complications.
If it's a larger jail, I wouldn't worry about it; they'll have medical staff on site to appropriately assess and treat, if needed. The only situation in which I would worry is if it's a smaller jail (and I mean really small--like unpopulated counties with no medical staff at all associated with the jail). I say this not with a medical background but instead with legal experience dealing with some cases regarding claims of civil rights violations for failure to provide adequate medical care. The vast majority of the time, everything is handled appropriately, though that may not be the story you get from your sister. As for not being able to do anything about it, that's not exactly true. You can inform the jail of her issues with addiction and your concern that she is likely suffering from withdrawals. If you're truly concerned about her safety, make a phone call, go up there, do whatever to make sure your concern is appropriately acknowledged. Chances are they're very much on top of it already, though.
ETA: And really, I would be most concerned if it was alcohol withdrawals; that seems to be what I've seen cause the most issues, but as a nurse, you know more about the specifics of withdrawals of different substances than I do!
Hello. I currently work inside county jail along with nurses and docs. We worry about alcohol withdrawals for DT's and benzodiazepines. We do nothing for meth users & manage opiate withdrawals. Where I work, there's no actual help ~ at least not the kind you're seeking or that she needs. She'll hate being incarcerated, but won't die given she doesn't have underlying issues. Judges can only impose so much...it's a major reason our systems are deemed inadequate. Don't get me started on the lack of mental health problems! Anyways, good luck ~ people do recover, but it has to come from themselves mostly. Also...this link is awesome.
As a corrections nurse most of the previous posters nailed it.
I would, however, encourage her to be housed in a recovery pod if the jail has one or participate in programs that focus on recovery such as Narcotics Anonymous.
I see this everyday and sometimes jail can be very sobering.
Be be supportive but don't cater to manipulative behavior.
Good luck! And if you need anything or live in Florida, I can steer you or your sister in the right direction. I work as a Discharge Planner for the jail as a nurse.
Your sister will get comfort meds at the very least. You should be able to call the jail to find out what kind of detox protocols they have. Opiate detox is pretty serious, yet quite common in jail/prison so trust that the nurses know what they're doing. They can also spot "fake" withdrawal symptoms that inmates have, just to get any med they can. I don't know how they do it in your state, but here we have an entire list of assessments that determine what the person would get, based on vitals and what part of the withdrawal process they're in. Good luck to you and her!
I worked as a jail house nurse for 5 years. Yes, I have seen Heroin addicts die. Every person is different and every person does withdraw differently. Bottom line either way is does she want to be clean? Because it will not matter whether she is in or out people find a way to get high, if she does not want to be free of the devil of addiction. Best wishes to you.
I worked as a jail house nurse for 5 years. Yes, I have seen Heroin addicts die. Every person is different and every person does withdraw differently. Bottom line either way is does she want to be clean? Because it will not matter whether she is in or out people find a way to get high, if she does not want to be free of the devil of addiction. Best wishes to you.
What was the physiologic process that ended in death from opiate withdrawal, dehydration ? Were they not monitored and treated for N/V/D ?
bgxyrnf, MSN, RN
1,208 Posts
Chemical dependency is not cause to deny someone their civil rights. While acutely intoxicated, she can be held against her will. If she is deemed an imminent and present danger to herself (that is, gravely disabled or suicidal), she can be held against her will. But simply being in the throes of drug addiction? Not in any jurisdiction of which I'm aware.
And the truth is, it wouldn't work. The only means to sustained recovery from chemical dependency is via a personal decision to do the lifelong hard work of recovery... hitting the so-called "rock bottom" from AA.
You simply cannot force somebody into sobriety.