Humane Detox
Carl recently committed a crime to pay for heroin and was arrested. Within 48 hours, he was curled up on his cell floor, shaking. He couldn’t move without throwing up and desperately wanted relief. He couldn’t stop thinking about heroin. Staff placed him in a single cell because he was so sick, and the toilet smelled of vomit. He was told “don’t do drugs”, and was not offered anything to ease the symptoms of withdrawal. He also feared he was being sentenced to prison. Craving relief, Carl decided taking his own life was better than the pain and anxiety he was experiencing.
Screen for suicide daily during withdrawal
Substance withdrawal can be miserable and may lead some people to consider ending their life when feelings of anxiety and hopelessness become too much to handle. Even if a detainee denies a desire to hurt themselves one day, the next day, their feelings may be very different. We strongly recommend screening for suicide daily during withdrawal using a validated tool, such as the Ask Suicide-Screening Questions (ASQ) tool. Any facility staff member can administer the ASQ. If a detainee says they are not thinking about hurting themselves but they act differently, trust your gut and put them on suicide watch. Screen for suicide daily during withdrawal.
Treat withdrawal (don’t stop cold turkey)
When someone is addicted to certain substances and stops “cold turkey”, it may cause medical problems. This could include seizures, heart problems, or strange behavior caused by psychosis¹. Cold turkey withdrawal may also lead to impulsive thoughts or actions, such as suicidal or homicidal behavior.
The medical, mental health, and security teams should work together to manage detainees’ withdrawal. Medical staff can assist with treatment of painful physical symptoms such as body aches, headaches, nausea, vomiting, and/or diarrhea. Dehydration due to vomiting or diarrhea may lead to death. Mental health staff can monitor mental status and suicidality, offer coping strategies, and/or help detainees learn to manage feelings of hopelessness.
If you think a detainee might be going through withdrawal or is about to, refer them to medical and mental health. Treat withdrawal (don’t stop cold turkey).
1. Hartney, E. (2022, June 10). Risks of quitting cold turkey. Verywell Mind.
For more information, please contact training@sparktraining.us.
Disclaimer
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. WHEN IN DOUBT, SEND THEM OUT. ®