Western Pennsylvania’s county jails grapple with addicts [The Pittsburgh Tribune-Review]

Dec. 20--With more drug-addicted inmates entering county jails, officials in one county are looking at programs to help inmates to kick their habits.

Fayette County Commissioner Vincent Zapotosky recently called for a review of treatment services available to inmates in the county lockup.

On Sept. 12, inmate Cade William Stevens, a Dawson man accused of robbing golfers at Linden Hall golf course, committed suicide. He was battling heroin addiction, his family said.

Stevens was imprisoned for less than 48 hours when he tied bed sheets to a cell bar and hanged himself, officials said. Two corrections officers were fired in an ongoing investigation. A coroner's inquest will be held early next year.

Zapotosky said he wants to ensure drug-addicted inmates are identified when they are committed.

"We need to review, medically, how we handle individuals who are addicted to make sure we're ensuring their safety, the safety of the other inmates and of the staff," Zapotosky said. He said the initiative was not tied to the Stevens case.

Opiate withdrawal can cause symptoms that include vomiting, abdominal cramps and muscle aches, said Dr. Ivan Montoya, acting deputy director of Pharmacotherapies and Medical Consequences of Drug Abuse for the National Institute on Drug Abuse, based in Rockville, Md.

Their severity depends on the level of addiction. Most addicts tolerate withdrawal symptoms, but death can result in extreme cases, Montoya said. Addicts with other medical conditions or severe dehydration are more vulnerable.

"Vomiting is the riskiest," Montoya said. "In someone who is debilitated by other diseases, or is severely dehydrated, it can be lethal."

A North Huntingdon man being held in the Westmoreland County Prison died as a result of a lack of treatment for heroin withdrawal, his family alleges in a lawsuit filed in U.S. District Court in Pittsburgh.

The lawsuit says Corey L. Kardos, 23, died March 9 after suffering for eight days with profuse vomiting, tremors, chills, weakness, dizziness, electrolytes imbalance, difficulty breathing and other symptoms.

The family alleges prison personnel ignored Kardos' oral and written requests for help. Guards allegedly beat Kardos when he took too long to put on his shirt, placed him fully clothed into a running shower and returned him to his cell in wet clothing.

County Solicitor Mark Gesalman and Warden John Walton did not return telephone calls seeking comment.

Fayette's Zapotosky said studies show some offenders commit crimes to feed an addiction to alcohol or drugs.

"These people will eventually be back on the street. The main goal of a correctional facility is rehabilitative, and I want to ensure that when they do hit the street, society is not exposed to more crime," Zapotosky said.

Treatment options vary by jurisdiction. Allegheny County has an entire cell block devoted to residential drug treatment.

Allegheny County Warden Ramon Rustin said there is a detoxification unit for severely addicted inmates who need supervision as they are weaned from drugs. In addition, the prison has a cell block set aside for inpatient, residential treatment.

"It's a licensed, 26-bed unit, and you have to request to be placed in it," Rustin said.

Allegheny County spent $52 million to house some 20,000 inmates in 2008, compared to $4 million Fayette spent on approximately 2,200 inmates that year, according to state statistics. Fayette's annual budget is about $21 million.

The Fayette prison offers weekly self-help programs through Narcotics Anonymous and Alcoholics Anonymous, state-funded programs that were eliminated for about four months during the budget stalemate, Deputy Warden Brian Miller said.

The programs were renewed several weeks ago as state funds became available for a counselor, Miller said.

Miller said inmates with severe drug addictions are referred to the county's mental health services department. Treatment depends on factors such as health insurance and space at facilities such as Torrance State Hospital in Derry Township, a psychiatric facility with 240 beds.

"If they are on welfare or a state insurance, they won't pay, so that's another bump in the road we have to deal with. And it comes down to bed space," Miller said.

Most hospitalization costs for uninsured inmates fall on county taxpayers. Under the Fayette contract with insurer Prime Care, it pays the first $2,500 in costs, with the county picking up the remainder, Miller said.

Pennsylvania spends $30 million annually on substance abuse programs for inmates in state prisons. The Department of Corrections reports that about 64 percent of new inmates abuse alcohol or drugs, a statistic in line with national trends. In 2007, about 13,000 state inmates underwent treatment.

In Indiana County, drug-addicted inmates are evaluated upon commitment, according to Warden Carol Hummel.

Programs are tailored to each inmate's needs. "There's no blanket, just do the same thing for everybody" policy, Hummel said.

On-site services include NA and AA programs and staff counselors. But Hummel said their effectiveness is constrained by the length of an inmate's stay. Hummel said most inmates spend 30 or fewer days in the Indiana system, which cost $3 million to operate in 2008.

"It's difficult, because when you are talking about county jails, they are here for only short periods," Hummel said. "They might be here for three hours, or up to two years."

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