The door leading to the intake unit at the Metropolitan Detention Center is shown in a screenshot of a promotional video from May 2018. (Courtesy of Bernalillo County)
For the past six months, Katherine Loewe has spoken on and off with a man incarcerated at the Bernalillo County Metropolitan Detention Center.
He is diagnosed with severe opioid use disorder, Loewe said, and when he was arrested and brought to the state’s largest jail in August 2021, he was up to date on a prescribed regimen of methadone. The treatment is used to reduce opioid craving and withdrawal, and blunt or block the effects of opioids.
Loewe is one of the attorneys in the decades-long class action lawsuit against the jail, McClendon v. Albuquerque. She was telling the man’s story during public comment at the monthly virtual meeting of the Addiction Treatment Advisory Board on Monday.
He’s aware that being in the facility, he is at an increased risk of relapse, overdose and death if he were to use in the facility or when he is released.
– Katherine Loewe, attorney
When someone with an opioid use disorder becomes the responsibility of the jail, medical staff are supposed to provide them with a dose of methadone, called an induction, even when they are a new patient, Recovery Services Chief Operating Officer Darren Webb said at a news conference in 2017. And withdrawal management was supposed to be a significant part of the contract with Corizon, said board member Dr. Rifka Stern.
Back-and-forth about whether the man was eligible for treatment and could provide proof of being a long-time addict stopped the jail from providing him methadone, Loewe said. But the man has a long history with out-of-state treatment in rehabilitation facilities, she said.
“He’s somebody I sat with, and he, you know, rolled up his sleeves, and rolled up his pant legs and showed me all of his track marks,” Loewe said. “And he said he was denied without anybody coming and talking to him.”
Loewe said “more than a handful” of people like him told jail officials upon intake that they were on methadone treatment, but instead of being given a dose, they were put into a detox unit for several days — sometimes more than a week.
“It was a concerning thing that I’d heard from more than just him,” Loewe told the board. “So, it’s wonderful that inductions are happening, but there’s this potential glitch that I’ve heard from more than one person.”
Withdrawal from opioids can be deadly. The man was really distressed, and remains so, she said, because he fears relapse.
“He’s aware that being in the facility, he is at an increased risk of relapse, overdose and death if he were to use in the facility or when he is released,” Loewe said.
The board consists of medical professionals and was created in 2017 to help advise the county government on its addiction programs, including the jail and the county’s CARE Campus, which provides detoxification and rehabilitation services.
Board Chair Dr. Dan Duhigg said one of the ideas behind hiring Corizon, the Tennessee-based medical provider that the county hired last year for $64.8 million, was that the company would be addressing withdrawal management.
He asked Sarah Cartwright, the company’s health services administrator at the jail, whether she knows how much and to what extent that is being done people inside the jail are experiencing withdrawal.
“No, I am not for certain. I don’t have that exact information that you need,” Cartwright said. “I can gather that and present it at the next meeting.”
Loewe’s comments follow other allegations that incoming inmates aren’t screened correctly when they’re entering the jail, according to a former worker who spoke with Source New Mexico on the condition of anonymity for fear of retaliation from Corizon Health.
Loewe said she doesn’t know if the delays in methadone treatment at the jail are caused by a disconnect between Corizon, which does the intakes, and Recovery Services, which actually administers the medication. None of the jail officials present at the meeting spoke up to clarify.
Board Member Dr. Anjali Taneja said she is also concerned about supervision of detox by nursing and doctors in the jail. Staffing has been a growing problem.
“I’m extremely worried, given that we’ve had 10 deaths at the jail during the COVID pandemic and before, and would love to hear from Corizon about what the plan is around that or where the current staffing is regarding that, because that is something that we as a board have been very concerned about,” Taneja said.
Our local governmental entities have not stepped up to meet this moment with the level of urgency needed.
– Dr. Anjali Taneja
Cartwright said as of Feb. 21, the jail was at a 42% staffing vacancy rate overall, only 2% lower than when Corizon took over in October 2021. She did not specify the medical staffing vacancy rate but said she has been interviewing candidates for nursing positions around the clock.
“We’ve had some individuals that we hired on and say for whatever reason, and then we had other individuals that resigned,” Cartwright said.
Taneja also asked who among the people incarcerated at the jail may be interested in starting Suboxone treatment. There should be information available from Corizon about that, she said, because everyone should be screened when they enter the jail about their history of drug use.
She said it would help to know what percentage of folks who go into the jail are dealing with addictions or substance use.
Cartwright didn’t have the data that Taneja was asking for.
MDC Director of Administration Roseanne Otero jumped in and said jail officials share patients’ medical records with Recovery Services, but Otero didn’t actually provide the data that Taneja was asking for.
“So, doctor, I’ll look into what kind of data we can provide, and we can look and see what we have, and you know, if it’s something that …’s readily- can be pulled or what we can specifically look at, then I’ll get back to you. I’ll let you know what we got,” Otero said.
The need to address high rates of opioid overdose deaths in New Mexico has become more urgent during the COVID pandemic, Taneja said.
In 2019, there were 599 substance abuse overdose deaths in New Mexico, making the rate of overdose deaths higher than the national average by 39.8%, according to legislative analysts who report that opiates are also often contaminated with fentanyl.
Coupled with the ongoing pandemic, this accelerated death and disability related to drug use statewide. Nationally, for the first time ever in 2021, the number of people who died from an overdose surpassed 100,000.
“Our local governmental entities have not stepped up to meet this moment with the level of urgency needed,” Taneja said in an interview. “This is reflected in both the care provided at the jail and in the community — in a county with significant funding for behavioral health that is directly funded by concerned taxpayers.”
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