Statistics show jail time is accurate predictor of potential to suffer opioid overdose


File photo of a naloxone kit.

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INDIANAPOLIS, Ind.-- Researchers from the Center for Criminal Justice Research at IUPUI have determined that spending a night in jail can be an accurate predictor of the potential to become victim to a fatal opioid overdose in Indianapolis.

“From 2010 to 2015, 33 percent of all people who died from heroin, had heroin in their system, 33 percent of those were in jail in the year prior to their death,” said Dr. Brad Ray who found most arrestees destined for a fatal overdoses were originally detained on non-drug related charges such as burglary or theft.

“We need to be doing screenings at jail to figure out if individuals have mental health problems, substance use disorders, and then routing them into appropriate interventions, whether that’s drug court, whether that’s treatment, whether that’s recommending them into those, getting them out into pre-trial release if they’re low risk individuals,” said Ray. “We have identified an intervention point and jail is an intervention point. They’re actually more like to have an encounter with jail in the year prior to their death than EMS.”

Indianapolis Emergency Medical Services set a record in 2016 by administering 1,818 doses of Naloxone to save the lives of patients overdosing on opioids, and is on a pace to beat that number this year.

Through Monday night, IEMS had administered 467 doses of Naloxone, compared to 333 doses during the same period a year ago.

“I can assure you nobody is overdosing thinking the lifesaving medicine is just around the corner,” said Dr. Dan O’Donnell, IEMS Medical Director. “Unfortunately there’s not that one quick fix, that one shot, that one intervention. These people require sometimes lifelong treatment that includes counseling, sometimes medication and treatment.”

Naloxone costs $40 per dose. The bill for an ambulance run is at least $1,500. The tab for a day inside the Marion County Jail, if medications are included, can top $90, meaning the cost to taxpayers can run into the thousands of dollars for just one overdose patient during the course of a year.

Ray and colleagues from IUPUI consulted with the Hogsett Administration to provide the statistical basis for the mayor’s criminal justice reforms which have resulted in a proposed half-billion dollar criminal justice center complex including a new jail with medical and treatment facilities.

“This is a more poignant intervention point,” said Ray, “so anything we can do there to divert people, we could effectively be reducing deaths if we intervene with even half those people.”

O’Donnell said that because of the potency of the heroin and fentanyl that is overdosing users, “there are a few runs where we’re needing higher and higher doses of naloxone,” to save patients, some of them on multiple occasions.

“It does happen from time to time,” he said, “and I think we’ve run numbers and its just about ten percent of the time we have repeat users, people who have gotten Narcan more than once.”

Still, researches claim users are not relying on the availability of Naloxone as an excuse to overdose under the assumption that someone will save them.

“Addiction is a disease and these people are having an emergency within their disease,” said O’Donnell.

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