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Mental health issues, drug abuse are the new norm at your county jail

By Billye Tollackson

CCRJC Health Care Manager

Recently, at the Chelan County Regional Justice Center, we booked a 33-year-old man into the facility who has acute systolic heart failure. He was admitted to the local hospital three times in the previous two months, leaving each time against medical advice. This man does not take his medications but abuses methamphetamine and fentanyl. Instead of being in the jail, he needed an echocardiogram and a cardiology appointment.

That same week, we also booked in a 48-year-old man who has a mechanical heart valve as well as hypertension, chronic systolic heart failure, atrial fibrillation and cirrhosis of the liver. The man was supposed to be on anticoagulation therapy; however, he had not been doing his therapy or taking his cardiac medication in months. He continues to drink alcohol.

These are only two examples of the serious and complicated medical issues that walk through the door of our local jail daily. We no longer are booking your standard “medically stable” people.

Exacerbating the issue is the fact that we have seen the use of prescription opioids, heroin and fentanyl skyrocket in our community. In the last two years, the chronic use of alcohol in our younger generation also has increased.

On top of this, it is no longer only our “regulars” who we see needing withdrawal medication. Because many people coming into the jail are new to us, we have no history of them or their addictions. They sometimes are delusional and psychotic. We are left to determine what we have in front of us – mental illness, drug abuse or both.

Although we have always treated withdrawal in the jail, we have never seen it this serious. There was a time when opioid withdrawal was “uncomfortable.” Today, it can be life-threatening. The drugs are changing. The amounts addicts are consuming is changing. And it continues to get worse.

I want to stress that the county jail does not have an infirmary; we are not a hospital, able to provide 24-hour medical care. But we do the best we can to catch all the acutely ill people as well as those who need care for their chronic diagnoses.

A year ago, we began a more diligent process when assessing the incarcerated population for withdrawals. It starts at booking to determine if someone shows signs of detoxing, or if people will provide us information of what they have been using. (Most do not want to provide this information.) A nurse is dedicated to assessing people for signs and symptoms throughout the day. We follow nationally recognized protocols and have developed a medication-assisted treatment program in an attempt to lessen withdrawal symptoms and severity. We also place all our high risk incarcerated adults in cells with cameras.

In addition, we have begun doing urine analysis drug tests as part of our assessments. We also test for Fentanyl, which is everywhere in our community. It is being added to pills, meth and more. And it is very dangerous. Some doses can be lethal just by touching it. We now have NARCAN at every tank, and we offer it to anyone who will take it at release.

Unfortunately, due to ongoing COVID-19 regulations, we are having to put our most high-risk adults in segregation for the first 72 hours of their incarceration. This time period is generally the worst of their withdrawal. Those in COVID segregation don’t have eyes on them constantly, and they don’t have cell mates to advocate for them if their health deteriorates quickly.

The news of two people dying while in our care has made headlines in our local media this past year. What I hope to convey is that we are caring for people who have not only chronic health problems but also mental health and drug addiction issues. And most times, all three. My staff will continue to work hard caring for the people incarcerated in our local jail with the tools and staff that we have. Even on those days that it is overwhelming.

Billye Tollackson is a registered nurse and the health care manager at the Chelan County Regional Justice Center. She oversees a four-member staff of nurses. She has worked for Chelan County for 20 years.

Last Updated: 01/19/2022 03:11 PM

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