Former inmates at high-risk of fatal drug overdoses

Montgomery County deputies responded to record 15 overdoses in 24-hour period.

More than 700 people released from the Montgomery County Jail since Jan. 1, 2013, have died — and nearly half succumbed to drug overdoses, data obtained by this newspaper shows.

Officials said former inmates are dying from drug use at an alarming rate, far higher than the general population.

Jail inmates are at an increased risk of overdose death after release because many are forced to abstain from using drugs while incarcerated and their tolerances diminsh, health experts and county officials said.

People who resume using the same quanities of drugs after a period of abstinence are more vulnerable to fatal poisonings.

County officials said they intend to develop prevention, treatment and intervention strategies to cut down on these preventable deaths.

“There is a pretty significant number of drug deaths post release,” said Montgomery County Commissioner Dan Foley. “It’s a reminder of the human toll that opiates are inflicting on our community.”

The region’s opiate epidemic is killing users, wrecking families and fueling crime that impacts the entire community.

Montgomery County Sheriff Phil Plummer said his deputies responded to a record 15 overdoses in a 24-hour period between Wednesday and Thursday mornings.

The county is working to finish a broad, high-level strategic planning process that will prioritize funding for human services programs that address pressing community problems, said Joe Tuss, Montgomery County administrator.

Opiate abuse and addiction is among the high-priority issues identified during that process, he said.

“It is a chronic health condition that we have to address,” Tuss said.

Between 2013 and 2015, about 717 people who were formerly incarcerated at the county jail died, according to data compiled by the county.

About 320 of those deaths (45 percent) were attributed to drug overdoses.

By comparison, about 743 people died of drug overdoses in Montgomery County during that three-year period, or 3.5 percent of all recorded deaths, officials said.

In all, about 78,311 people were released from the county jail during that time.

Many inmates who stop using drugs while locked up will relapse after being released.

The average length of stay at the jail is about 12 days.

Users who detox in jail, return to the community and procceed to ingest the same quanities of drugs as they did before lock-up face a substantial risk of a life-threatening overdose.

Users can build up tolerances that require many times the original dose of a drug to produce the desired high, but upon release, the risk factor is they are clean, experts said.

“Their body is cleansed of the opiate, they put it back into their system and it overwhelms the receptors in their brain, and that is what causes the overdose,” said Jodi Long, director of community behavioral health operations with Montgomery County Alcohol, Drug Addiction and Mental Health Services.

Jails, rehab centers and hospitals try to educate drugs users before release not to quickly return their normal levels of use, she said. But officials said more must be done to drive the message home.

The county jail regularly shows a video from Project Dawn on this subject, warning inmates about the dangers of overdose after they are clean for a spell, said Joe Spitler, the county’s director of criminal justice under the board of commissioners.

The jail plans to show the video more frequently on a loop to inmates, and it also wants to run the video in waiting rooms to inform family members and friends of the risks, he said.

Since late 2014, the county has partnered with Cornerstone Project to provide substance abuse treatment for inmates starting in jail and continuing after release, including counseling and medication-assisted treatment, Spitler said.

Some addicts receive Vivitrol shots, which blocks the effects of opoids for nearly a month.

The majority of program participants remain engaged in treatment. However, nearly three-fourths were ordered by the court to undergo treatment. Only about 29 of 107 clients requested the treatment of their own accord.

On Wednesday, about 755 people were at behind bars at the county jail, including 419 inmates who had histories of drug arrests.

Sheila’s son is one of the inmates with a drug problem.

Her son is addicted to heroin and earlier this year overdosed after being released from lock-up. Sheila, who lives in the county, said he’s only alive today because he was administered Narcan, an opiate antidote.

Sheila, who did not want her last name published, said she believes her son can become clean since he has been ordered into treatment after release, and after treatment, he will receive a Vivitrol shot.

“He’s ill — his brain has been hijacked,” she said. “But he can live a normal life — I know that to be so.”

It can be difficult — if not impossible — to help drug users who do not want help and are not forced into treatment by the judicial system, said Commissioner Foley.

But the jail provides an opportunity to identify community members who are at a high-risk of overdosing, he said.

Hopefully service providers can develop measures and programs to prevent fewer overdose deaths in the future, even among people who will not stop using narcotics after getting out of jail, Foley said.

Sheriff Plummer said the county has insufficient drug treatment options available at a time when the heroin problem spiraled out of control.

Plummer said he would like his jail to have Vivitrol to provide to departing inmates because it can help them stay sober.

“The most heartbreaking thing is people call looking for treatment, and we can’t get them in anywhere,” he said. “We need to grab them as soon as they are leaving jail and get them into treatment and mentoring programs.”

There are many addicts who never encounter the criminal justice system who must also learn about the risks of relapsing after a period of being clean, maybe at hospitals or other social service programs, said Barb Marsh, assistant to the health commissioner with Public Health - Dayton & Montgomery County.

People can recover from even the most powerful addictions with the right treatment, support systems, understanding of their chronic illness and personal commitment, she said.

Addicts “need to be able to learn a different way of living and really is changing their whole lifestyle,” she said.

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