With overdose rates rising, correctional facilities are playing a critical role in substance use treatment. Elliot Wade, MD, corporate medical director(western states) at NaphCare, discusses the most common disorders, overdose prevention strategies and how care is managed inside the system.
Dr. Elliot Wade
What are the most common substance use disorders you see among people entering local detention facilities?
Most commonly, opiate use disorder—primarily fentanyl and heroin—alcohol use disorder, and stimulant use disorder, primarily methamphetamine.
Nevada has seen rising overdose rates in correctional settings. What steps can facilities take to prevent overdoses?
It is key for correctional facilities to have comprehensive, evidence-based treatment and medication protocols for treating acute opiate withdrawal and opiate use disorder.
Partnership between health care providers and correctional staff is vital. Clear, consistent communication and alignment between treatment protocols and security procedures ensure a coordinated approach to treating patients while also preventing onsite overdoses.
One step in preventing overdoses is Narcan. This safe, life-saving medication should be available to all staff—and even on patient housing units—with education on how and when to use it.
How does treatment inside a jail differ from treatment in a hospital or clinic?
Correctional facilities can make a significant impact in this area. Many times, we are on the front line. From the standpoint of diagnosis and medications, it may not be that different. However, the circumstances are often different. In general, patients voluntarily attend clinics or arrive at a hospital versus a jail, where patients arrive involuntarily.
The added layer of the courts and legal proceedings are also different. For example, there may be instances where treatment is impacted by what is happening with the courts, by a transfer to another correctional facility or by sentencing.
NaphCare aims to stabilize patients with substance use disorder while they are under our care. We then partner with community clinics to create a plan for continued treatment upon release that bridges the gap between the jail and the community.
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