Until this year, people were dying in the Pima County Jails at higher rates than the rest of the country. But, an innovative opioid treatment program there is changing that.
This year, there was a single death in the Pima County Jails, a major shift from just the year before.
John Washington has been reporting the story for Arizona Luminaria in Tucson and joined The Show to discuss.
Full conversation
JOHN WASHINGTON: This program began as sort of a pilot in 2015. And at that point, it was addressing only pregnant women who were suffering from opioid addictions and it's been slowly expanded since then. The biggest expansion came earlier this year in January.
And at this point, over a third of everyone who's in the Pima County Jail is receiving what's called medication assisted treatment, where they're actually getting a form of medication that helps lessen the worst withdrawal symptoms of people who are not getting their standard opioid doses that they were taking on the outside.
And they also get other forms of help, including some therapy in and on their way out of the jail. They get linked up with other service providers in the community and they get some Narcan and some basic information if they have struggles again on, on, on the outside.
LAUREN GILGER: Are these always cases that are related to or tied to in some way opioids? Like does that tend to lead to why these folks are often in jail?
WASHINGTON: Well, in, in a lot of cases, yes, this specific treatment only addresses opioids, and a lot of the folks who are in the throes of addiction also are suffering in other ways or are criminalized in other ways because they may be unhoused, they may be committing petty crimes, and it's all wrapped up together. And so, yes, more and more people are either suffering from a mental illness or suffering from a substance use disorder who are in the right now.
GILGER: Yeah. So you're reporting here that this program is not just working, it seems to be working pretty well. You reported there has been a single death in the jail in the last 13 months.
WASHINGTON: There's been one death in the jail in the last 13 months, which is a steep, precipitous drop from the years that we were seeing before; 2020 through 2022 and 2023, people were dying in the county jail at a high above average rate. And all of a sudden it stopped.
There's a number of factors and this, officials say, is, is one of the major ones that a lot of those deaths were either from drug overdoses from withdrawal or suicides. And this addresses all three of those issues. It’s getting people on medication that really lessens the most severe symptoms of withdrawal and helps them start to cope as they're coming down from opioids.
GILGER: And just so folks understand, John, describe for us a little bit about what those withdrawal symptoms from opioid addictions can be like because if you're arrested, you are suffering from addiction, you are taken away from any access to those drugs you can go into pretty severe withdrawal pretty quickly.
WASHINGTON: Yeah, they're really brutal and, and one of the other things that the jail has done is they are putting almost everyone who enters into the jail system now into a detox protocol where they are much more strictly monitored than previous. And what it looks like is people having high fever, people shaking, people vomiting, people really, really struggling, especially in the first few days, if they're not getting their, what had become a standard dose of opioids.
And it can lead to death and heart failure and, and, and people really, really struggle with it and, and so yeah, this is just trying to get people through like the, the, the drugs that are being in this, trying to get people through those early stages of that, that really intense withdrawal.
GILGER: OK So talk a little bit about how this program is being funded. It's not cheap, right?
WASHINGTON: No, it's not cheap at all. It's, it's incredibly expensive. We do not yet know exactly how much it's costing. The medical care that's provided in the jail already costs a lot. It costs the county nearly $20 million a year. So, you know, that's well over a million dollars a month, and these new programs are in addition to that.
So because of the way that it's contracted and subcontracted, county officials couldn't give me a precise number yet, but that's something we're looking into. But we also know that withdrawals and overdoses cost a lot no matter what. So the the price of what the hospitals had to pay for treating overdoses in just 2023 was over a third of a billion dollars in county. It's extraordinarily expensive.
It's far higher in Maricopa just because Maricopa, just because it's, it's such a bigger county. So people are trying to do a little bit of cost-benefit. I mean, of course, you know, you can't really put a price or value on someone's life or on treating someone, but they recognize that this is going to be expensive, either if we treat it beforehand or afterwards and it just makes a little bit more moral sense to treat it up front.
GILGER: So there is conversation about continuing this funding and where that money is going to come from going forward, it sounds like.
WASHINGTON: There is, there seems to be interest right now. This money is coming out of the county's General Fund. There is also some additional funds coming from some of the opioid settlement funds and, and that is mostly directed towards the release planning. So what happens and how people are helped or guided as they're leaving jail to continue some form of treatment.
GILGER: OK, OK. So this comes, John, as there's a broader conversation going on in state government about spending opioid settlement funds at the state level to go to the Department of Corrections. This was a dispute between the Attorney General Kris Mayes and the governor. And the attorney general had argued that this was a misuse of these funds. They were meant to curb the opioid crisis, not sort of fund the DOC.
Is this showing at least one way maybe in which using these funds in a correctional kind of setting might be productive?
WASHINGTON: That's what it seems to be. You know, that is a complicated dispute and there are a lot of factors there. But what we can see in Pima County, I think this holds true for other counties in Arizona, is that a lot of the people who are getting this treatment are receiving it for the first time or the first time in a while. And that's because they just don't have contact with other medical service providers very much on the outside.
So when they're in the jail, and this is officials readily admit a sorry state of our society, is the only place that they're able to receive quality medical care. And so county officials think, well, they're there, we might as well give it to them. And, and because they're probably not going to access it in the same way on the outside.
GILGER: Interesting. John, let me ask you lastly, before I let you go, is this program unique to the Pima County jails? Like, is there anything being done like this elsewhere that you know of?
WASHINGTON: It is being done elsewhere but seemingly not to the degree that is happening in Pima County. Pima County has really been in a number of different ways in the forefront of trying to think about health care in the jail setting. And as far as we can tell, Pima County is taking a much more aggressive treatment plan than, than other jails, at least in Arizona and, and perhaps throughout the country.
