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Civilian review board recommends jail inmates be given access to naloxone

The Citizens’ Law Enforcement Review Board voted unanimously Tuesday to recommend that the San Diego County Sheriff’s Department give people incarcerated in its jails access to naloxone, a life-saving medication that can reverse an opiate overdose.

Currently, jail deputies carry doses of naloxone, which is administered via nasal spray, and have used it dozens, if not hundreds, of times. But correctional health care experts recommend inmates have easy access to it in living units so that a person who has overdosed receives naloxone as soon as possible.

The review board’s policy recommendation mirrors guidance from the National Commission on Correctional Health Care, which recommends that naloxone “be ‘readily available’ to all people in a facility, to include inmates” and that “inmates receive education on ‘opioid overdose and its signs, correct technique for administration of naloxone and, essential procedures, including performance of cardiopulmonary resuscitation.’”

Review board Executive Officer Paul Parker said Tuesday that the policy recommendation “seems like the next reasonable step to attempt to minimize, reduce the deaths that are occurring.” The board provides civilian oversight of the San Diego County Sheriff’s and Probation departments.

The Sheriff’s Department is not required to enact review board recommendations, but generally does. A department spokesperson did not respond to questions from The San Diego Union-Tribune.

A report by the firm Analytica Consulting on mortality rates in San Diego County jails, released last month and commissioned by the review board, found that people in San Diego jails have the highest rate of overdose deaths among California’s 12 largest counties.

Last June, The San Diego Union-Tribune reported that overdoses in local jails had jumped from 11 in 2018 to 75 in 2020 to 53 in the first five months of 2021. One deputy said at the time that it was the worst he had seen.

“Inmates use the drugs even after watching guys OD the day before,” he said.

It is unclear how opiates get into San Diego County jails. During intake, arrestees are verbally warned that smuggling drugs into jail through a body cavity can be deadly. Jail staff relies on body scanners to identify contraband, but the machines are not completely reliable, officials say.

Current and former inmates have told The San Diego Union-Tribune that people turn to smuggled drugs to offset the side effects of opiate withdrawal, which can last for days and include vomiting, seizures and muscle pain.

Last year, the Los Angeles County Sheriff’s Department launched a pilot program that placed two naloxone doses in each unit of the North County Correctional Facility in Castaic. A month after the launch, inmates were credited with using the naloxone to save the lives of two men who had collapsed after ingesting fentanyl, a powerful opiate.

Aaron Fischer, who is part of a group of attorneys suing the San Diego County Sheriff’s Department over medical and mental health care in the jails, described giving inmates access to naloxone as “a safe, common sense, urgently needed measure to save lives.”

“Other jail systems, like Los Angeles, have taken this step, and we know that lives have been saved as a result,” Fischer said. “Why is the jail system here waiting to protect San Diego County residents?”

Last week, the attorneys filed a motion in federal court, asking a judge to immediately order the sheriff to give inmates access to naloxone. The filing also asked that the jails be required to overhaul the unreliable body scanner system and implement medication assisted drug treatment, which eases the effects of withdrawal.

Gretchen Burns Bergman, the executive director of the nonprofit A New PATH, for Parents for Addiction Treatment and Healing, welcomed the news about the policy recommendation.

“Naloxone should have already been made ‘readily available,’” she said, “but this is good.”

In 2020, near the start of the COVID-19 pandemic, A New PATH had provided the jail with 1,000 naloxone kits for people being released early, along with a short training video on the proper use of the nasal spray. But, as The San Diego Union-Tribune reported, the kits were never distributed; the department ultimately returned them because they had expired.

A New PATH provided more than 1,000 additional kits, but those also went unused, Bergman told reporters.

A Sheriff’s Department spokeswoman said the kits were not distributed because the department had not reached an agreement with the Service Employees International Union, which represents medical staff, who were going to distribute the kits.

The Citizens’ Law Enforcement Review Board also approved a second policy recommendation Tuesday, asking the Sheriff’s Department to create policies and procedures guiding the use of its fentanyl-sniffing dog. The review board found that no such policies currently exist.

The recommendation says the dog should be used to search all areas of the jail and all people entering the jail “to include visitors, inmates, and staff; and to conduct sniffs of persons already inside of a facility, to include visitors, inmates and staff.”



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