Meds & jail

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I've worked in detox's before but never a jail/prison setting I wanted to get some insight on how the system works in Massachusetts.- I've tried to research this but can't find an answer, if,- (for EX,) an inmate is prescribed Xanax BEFORE incarcerated. Would he be prescribed that in jail?- one thread I found (didn't say state) said that the jail would use one type of benzo in every case- just adjust the mg according to patient/inmate.- but to me this doesn't seem helpful or ethical. If there is an inmate who is diagnosed w GAD. & panic attacks etc. & (before)incarceration is on klonopin or Xanax. & another inmate is prescribed Valium prn. For sleep- & let's just say the jail's "ONLY" benzo is Librium, it could work for inmate #2- but inmate #1 is going to suffer - both Benzo but completely diff. If ANY1 has knowledge thoughts or opinions, please share.

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Specializes in Psych ICU, addictions.

That would depend on your prison's P&P. For the patient to stop Xanax cold turkey can be very dangerous, especially if he/she has been taking it for an extended period. I would hope that if they weren't going to continue the patient's alprazolam, that they would substitute another benzo to prevent withdrawal complications.

And using Librium may not necessarily mean that patient #1 in your example is going to suffer. Klonopin is a mid-range benzo; they'd be getting long-acting Librium in it's place. And the prison may opt to use a non-benzo anxiolytic such as Vistaril and Buspar in lieu of Xanax.

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Specializes in Outpatient Psychiatry.

The local county jail in my neck of the woods does not order or dispense anything that is a controlled substance, I.e. nothing Schedule V-II(I).

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The local county jail in my neck of the woods does not order or dispense anything that is a controlled substance, I.e. nothing Schedule V-II(I).

Wow. That is actually cruel and unusual punishment.

Bet it makes the natives quite restless ,as well.

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Specializes in Psych.

If we know a patient is being discharged to jail the doctor works with the jail and only prescribes meds that with will continue because like psych guy said our local jails do not prescribe any controlled substances.

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Specializes in med/surg.

This is an interesting topic-and one I am considering for a masters thesis. I think it could be a really awful thing if meds such as benzos or narcs aren't provided and prisoners go into withdrawals in jail, among other ethical issues. Anyone else have anything to add? Because I'd really like to hear...

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Specializes in Psych.

My cousin was on a methadone program when she was arrested for a probation violation ( FTA I think) had to detox of methadone in jail. Been told by patients they will say they are suicidal to be admitted to the unit so they can detox more comfortably.

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Specializes in Psych ICU, addictions.

An opiate detox, though exceptionally miserable to endure, will not kill the patient. There are non-narcotic/non-schedule comfort meds that can be given to help manage the side effects (APAP, Bentyl, Immodium, Zofran, etc.).

A benzo detox does have potential for serious complications...but that can be carefully managed by a long-acting benzo taper. Another non-schedule medication would have to be introduced to manage anxiety PRN. Keep in mind that the goal of getting through a detox is SAFETY, not comfort. I'm not saying we shouldn't make patients comfortable because we should do what we can whether it's a jail patient or a VIP at the Ford Clinic.

But the reality is that a detox will never be 100% discomfort-free. And if they've been numbing their anxiety with Xanax for years, they are going to have to get used to feeling those emotions again.

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