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Patient Before Inmate: Managing Safe Detox Protocols In Custody
- Apr 7
- 2 min read
Nearly 48 million Americans - 1 in 6 people - had a substance use disorder in the past year, according to the most recent national survey data. That includes dependence on alcohol, illicit drugs, and prescription meds.
Addiction doesn’t discriminate. It doesn’t care where you come from, what your background is, or how much education you have; it affects parents, children, neighbors, coworkers. It doesn’t care what kind of bad decisions it makes you responsible for. Because of that it intersects with the justice system in profound ways.
Research shows that addiction is far more common among people who have been incarcerated and the majority of them met criteria for a substance use disorder at the time of admission.
And then withdrawal begins.
Safe management of withdrawal in custody starts at intake, but it should not end there. The symptoms don’t present themselves immediately; they start and build, often peaking DAYS after booking, so it is imperative that a patient’s symptoms are being monitored regularly and carefully to avoid danger.
Withdrawing from things like alcohol or benzodiazepines can escalate unpredictably — far beyond the initial hours. Because of this, facilities that are responsible for medical care must be able to do more than acknowledge risk. It’s not just an “uncomfortable experience”. It is physiological. It is medical. It needs attention.
The U.S. DOJ Bureau of Justice Assistance & National Institute of Corrections states:
“Best practice guidelines for withdrawal management recommend that, for individuals in custody who are intoxicated or undergoing withdrawal, correctional facilities should:
(1) allow qualified healthcare professionals to monitor those individuals within a safe housing environment;
(2) incorporate specialized treatment for pregnant and postpartum individuals;
(3) create defined protocols to prevent suicide and self-harm during and after cessation of substances; and
(4) initiate or continue clinically appropriate medications, including medication for addiction treatment (MAT), such as buprenorphine and methadone.”
Detoxing is 100% guaranteed to be uncomfortable, painful, miserable but it should never be fatal, even in custody. If withdrawal symptoms exceed what can safely be handled within a facility, a transfer to a hospital or higher level of care is absolutely necessary.
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