Rikers closure plan falls short

Rikers closure plan falls short

Mayor de Blasio has overlooked a major problem: addicts and alcoholics suffering withdrawal behind bars.

Rikers Island, as seen on Jan. 2, 2018.
Rikers Island, as seen on Jan. 2, 2018. Photo Credit: Virgil’s Real BBQ

Despite pushback, Mayor Bill de Blasio’s plans to close the decrepit Rikers Island detention facility are well-intended. But he’s overlooked a major problem: addicts and alcoholics suffering withdrawal behind bars.

According to city figures, 17 percent of the 55,000 people admitted annually to NYC’s jails are in acute opioid withdrawal, which can lead to dangerous profuse vomiting and defecation. Recently, an inmate in Pennsylvania died despite cellmates’ repeated pleas for assistance, and another in Ohio died despite the facility’s medical addiction protocol.

These situations call for medical personnel, not just medicines. As The New Yorker noted, withdrawal “can require close monitoring and specialized treatment that jail wardens are not equipped to provide.”

Nationwide, Mother Jones found 20 lawsuits filed from 2014-16 alleging inmate deaths from opiate withdrawal complications — likely a mere fraction of the actual total of fatalities. It also doesn’t reflect withdrawal from alcohol, which carries grave risks of nonclinical detoxing, including seizures and the substance-specific delirium tremens.

But despite improved safety being a tenet of NYC’s jail improvement initiative, the word “withdrawal” appears exactly zero times in the 53-page plan to close Rikers Island.

NYC regularly treats opiate-dependent inmates with methadone, a weaning agent. However, merely distributing meds won’t alleviate the relentless vomiting and defecating that can cause long-term health issues or death. Likewise, drugs intended to curb cravings for alcohol do not address alcohol’s withdrawal symptoms, most notably seizures.

The story of withdrawal oversight in America’s jails is one of convincing facts met with half-measures. An instructive paper from the Center for Health & Justice titled “Safe Withdrawal in Jail Settings” notes that 64,000 Americans died from drugs in 2016 (the number climbed to 72,000 in 2017), and 20.1 million people reported substance abuse issues in 2016.

The paper then cites an alarming statistic: Nearly two-thirds of people serving sentences in jail meet diagnostic criteria for drug dependence or abuse. Incredibly, those data are from 2007-09 — before the opioid crisis and its record addiction and death totals. And since detained alcoholics and drug abusers are being separated from their substances by metal bars, jails are often ground zero for withdrawal symptoms to begin or worsen.

Given the undeniable link between jails and dangerous withdrawal from drugs and alcohol, why aren’t adequate detox infrastructure and medical personnel part of NYC’s plans to modernize its jails?

Amid encouraging recent law enforcement efforts pertaining to drugs — especially equipping police with opioid overdose-preventing naloxone — it only makes sense to improve safety at a detainee’s first true danger point. Any workable plan to replace Rikers Island should include proper detox facilities at new NYC jails.

Christopher Dale is a freelance writer who writes on society, politics and sobriety-based issues.

Christopher Dale