By Jeff McDonald & Kelly Davis
In 2018, there were 11 overdoses on drugs in San Diego County jails, Sheriff’s Department records show.
Already this year there have been at least 53 overdoses, including a 12-day spate in May in which 20 people at four different jails were administered naloxone, emergency medication to keep them from dying.
Illegal drug use has exploded in San Diego County jails, no more aggressively than over the past few weeks and months.
On May 18 alone, eight people incarcerated at the George Bailey Detention Facility overdosed on fentanyl, the department said. Even before then, the jails were on track to far outpace the number of times deputies and medical staff administered naloxone in 2020.
“It’s worse than I’ve seen,” said a jail guard who is not authorized to speak to reporters. “Inmates use the drugs even after watching guys OD the day before.”
The number of in-custody overdoses jumped more than five-fold between 2018 and 2019, when 57 inmates were found in medical distress and given doses of naloxone. Last year the total of overdoses climbed to 75 people across the county’s seven-jail system.
Many of this year’s 53 inmate patients have been hospitalized, and so far only one person has died, according to department reports.
Traces of fentanyl were found in 35-year-old Jonathan Whitlock’s blood, an April 28 Sheriff’s Department news release said. He had been incarcerated at George Bailey.
Two other men have died behind bars this year: one suffocated on a face mask and the other’s death has yet to be publicly disclosed.
Last year five men died fentanyl-related deaths in San Diego County custody.
Aides to Sheriff Bill Gore say the crush of jailhouse overdoses reflects the growing presence of fentanyl across the broader community. They say the department is doing everything it can to prevent overdoses and protect inmates.
“Many of the incidents we experience in our facilities mirror those found in the community,” spokesperson Lt. Amber Baggs said in an email. “This translates to an increased demand and market for fentanyl inside of our jails.”
The assertion is backed up by county research that shows fentanyl-related deaths in the community tripled from about 150 in 2019 to more than 450 last year.
A separate report released by the San Diego Association of Governments in October said “fentanyl” was the most common answer when arrestees were asked if they had abused prescription drugs in the previous 30 days.
The Sheriff’s Department acknowledges it has more work to do to protect people who are locked up and to prevent narcotics from being smuggled behind bars.
Fentanyl is a synthetic opioid that can be as much as 50 times stronger than heroin. Because a small amount can be deadly, it is difficult to find and confiscate, despite all the measures taken by the department.
“To keep illegal drugs from entering county jails, we’ve made investments in equipment and technology, utilizing specialized resources and integrating investigative methods to provide a safe environment for our staff and individuals in our custody,” Baggs said.
“Despite these efforts, drugs are making their way into our facilities.”
Sometimes drugs are hidden inside people’s bodies as they are being booked into jail, the department said. They also have been sent in through the mail or brought in by jail staff.
Jail officials rely on body scanners when arrestees are booked into custody, but the machines do not always identify contraband as it is being snuck in, the department said. The intake process also includes verbally warning inmates that drugs can be dangerous — to use or to ingest as a means of hiding them.
Deputies also conduct random searches of cells that may include drug-sniffing dogs. The department also maintains “no questions asked” drop boxes, where illegal drugs can be placed without recrimination, Baggs said.
“There have also been instances of visitors bringing drugs onto jail property with the intent of getting the drugs inside the facilities,” she said. “These incidents have resulted in criminal investigations and arrests.”
The unnamed jail deputy said a new mail-screening system has cut back on what used to be the most prevalent way of sneaking drugs into jails.
Body scanners also have helped reduce the flow of illegal drugs into county jails, he said, although many of his colleagues have yet to be properly trained to find everything that appears in the images. And canine searches are rare, he said.
“The drug dogs are not allowed to be used during searches because they don’t want to endanger the dogs,” he said. “But it’s OK to send in deputies to search for drugs.”
Experts say one reason so many inmates appear to be using fentanyl and other substances behind bars is because they already are addicted to opioids when they arrive at jail.
As a result, many jail and prison systems have implemented a medication-assisted treatment program, or MAT, which includes regular doses of methadone or Suboxone to curb painful physical withdrawal symptoms. The medications alleviate a person’s cravings for opiates without causing a high.
Leo Beletsky, a professor of law and health sciences at Northeastern University, said it is counter-productive to not employ medication-assisted treatment in jails and prisons.
“The fact that we incarcerate folks with substance use and do not provide them with adequate and scientifically based treatment — and essentially force them to go into withdrawal — is not just inhumane but dangerous for the people incarcerated and for the staff,” he said.
In correctional settings, medication-assisted treatment “should be just like any other medication,” Beletsky said. “They should be screening everyone for opioid use disorder and prescribing MAT. And, when people are being released, getting them connected to care.”
But there is significant stigma tied to using medication-assisted treatment and a belief that overcoming addiction requires facing a difficult withdrawal process, he said.
“There’s a lot of foot-dragging,” Beletsky said. “The point is for people to get their lives back and be able to function. What someone else defines as ‘sober’ shouldn’t have any bearing on someone’s course of treatment.”
Gretchen Burns Berg- man, the executive director of a Spring Valley nonprofit called A New PATH (Parents for Addiction Treatment and Healing), has seen the benefits of medication-assisted treatment firsthand.
Bergman’s son struggled with opiate addiction. Once, when he was in jail, Bergman was able to bring him Suboxone to help ease his withdrawal symptoms.
But during a subsequent incarceration, a sympathetic judge agreed to release the young man because he believed he would be better off continuing his treatment outside of jail due to the lack of in-jail services, Bergman said.
One of the chief missions for A New PATH is to make medication-assisted treatment more widely available, to people who are in custody and those who are released from jail without support services.
In an interview last week, Bergman told The San Diego Union-Tribune she thought the jails had implemented a medication-assisted treatment program. Indeed, the department told the Union-Tribune in 2019 that the department was “currently receiving training on how to effectively implement a medication assistance treatment program in our facilities.”
More than 18 months later, the department said the program was still being developed. Bergman said it was infuriating to hear this.
“We’re so far away from what we need to see with treatment on demand, it’s just heartbreaking,” she said. “Everybody understands the need for harm-reduction strategies. You have to meet people where they are.”
Last summer, as hundreds of inmates were released early to prevent the spread of COVID-19, A New PATH gave the Sheriff’s Department more than 1,000 naloxone kits, along with a short training video on the proper use of the life-saving nasal spray.
But the kits were never distributed. The department returned them in October because they had expired.
A New PATH then provided another 1,000-plus kits, but those also went unused.
“We thought we had all the details ironed out,” Bergman said.
Baggs, the sheriff’s spokesperson, said the holdup was due to a county rule that requires the sheriff to get approval from the Board of Supervisors to accept naloxone donations, a vote that did not happen until September.
Then, because the plan was to have medical staff distribute the naloxone, the department also needed the Service Employees International Union to sign off.
“To date, this process is not completed,” Baggs said.
After contacting Sheriff Gore last week about the unused naloxone, Bergman was assured that deputies would be providing inmates with the naloxone kits upon release.
Baggs said the Sheriff’s Department is currently participating in a statewide program that promotes medication-assisted treatment in jail systems across California, but the San Diego effort is so far limited to pregnant inmates who already are prescribed methadone.
“We have every intent to have a robust MAT program in the county jail system in the near future,” she said.
firstname.lastname@example.org Davis is a freelance writer.