Tag Archives: jail

Louisville: Jail Among The Solutions

In Louisville the other day, I wanted to see how jail was changing in America.

This epidemic of opiate addictions  calling on us to reexamine a lot about how we live, our values, culture, ideas and institutions we’ve taken for granted.

One of them is jail. Jail has always been a crippling liability in our fight against drug abuse. Jails are usually places where humans vegetate, sit around, argue, learn better criminal techniques, then get out weary and stressed and, if they’re addicted to drugs, they head straight to the dealer’s house.

This epidemic is forcing new ideas. One of them is jail turned into an asset, a place of nurturing, of communion as addicts learn to help each other.

That’s a bizarre concept. I never thought I’d write “nurturing” and “jail” in the same sentence, but it’s happening.

The state of Kentucky seems furthest along in all this. I wrote an Op-Ed column for the NY Times about a visit I paid to the jail in Kenton County, Kentucky. Yet what’s being tried in Kenton County – and a couple dozen other county jails in Kentucky — began in Louisville – in Metro Jail.

Why jail?

Well, if “we can’t arrest our way out of this,” as is so often said, then we need more drug-addiction treatment. Yet this epidemic has swamped our treatment-center infrastructure. New centers are costly to build, politically difficult to site, and entering them is beyond the means of most uninsured street addicts, anyway.

I know that jailing addicts is anathema to treatment advocates. But opiates are mind-controlling beasts. Waiting for an addict to reach rock bottom and make a rational choice to seek treatment sounds nice in theory. But it ignores the nature of the drugs in question, while also assuming a private treatment bed is miraculously available at the moment the street addict is willing to occupy it. With opiates rock bottom is often death.

Jail can be a necessary, maybe the only, lever with which to encourage or force an addict to seek treatment before it’s too late. In jail, addicts first interface with the criminal-justice system, long before they commit crimes that warrant a prison sentence. Once detoxed of the dope that has controlled their decisions, jail is where addicts more clearly behold the wreckage of their lives. The problem has been that it’s at this very moment of contrition when they have been plunged into a jail world of extortion, violence, and tedium. It’s a horrible waste of an opportunity, and almost guarantees recidivism.

With this epidemic, though, we’re seeing new approaches – jail as a place of rehabilitation, a place where recovery can begin.

Several years ago, as heroin began to grip the area, the Louisville jail saw inmates dying from overdoses.

Mark Bolton, the jail’s director, said the spate of deaths forced new ideas.

“We modeled a pod on outside treatment (centers),” he said. “It became a matter of taking the resources we had and repurposing them. We sent people [to drug rehabilitation centers on the outside] and found out how they run their peer detox program. We learned from them.”

Louisville Metro began with female inmates. Those who were just off the street and detoxing, and who normally were spread across the jail, were placed together in one pod, christened Enough is Enough. This allowed more focus on their needs, and got them away from other inmates who were angered by their withdrawal symptoms, which included vomiting, diarrhea, screaming, insomnia and more.

Jail officials began allowing people in recovery into the detox pod as well. These recovering addicts mentored the new arrivals – washing and soothing them. Officers preferred it, as they no longer had to clean up vomit and diarrhea.

In addition to bathing and caring for those in withdrawal, inmates take classes in relapse prevention, understanding criminal thinking, accountability, parenting, and more; they run their own 12-step groups.

As the Enough is Enough pod began to function, there were fewer fights, less contraband. “Inmates into their recovery and into their sobriety are self-policing. The wear and tear is less,” Bolton said. “After we worked out the bugs, we began to see some of these people show progress. The inmates into their treatment appreciated the fact that they were caring for a human being that was at a place where they had been once.”

When they leave jail, they’re given a Vivitrol shot, which blocks opiates, and they were connected with housing and follow-up Vivitrol shots.

The jail now has the one women’s pod and three pods for men: 56 detox beds and 64 recovery beds, total.

I visited the pod – with about 30 women, four of whom were detoxing. The walls were covered with art work.

(Click here to hear the end of the pod’s afternoon meeting that day.)

It seemed, finally, a nurturing place in jail – far more about recovery than its connecting pod, where fights and loud noise were common until the early morning.

I spoke at length with a woman named Kara, whose addiction was more than 20 years old. This was her 17th time in jail. She had come from washing the vomit off another woman who had just arrived in the pod.

Here’s our interview:

The Louisville jail experiment isn’t a cure-all – no one thing is for this opiate-addiction epidemic. And the jail has difficulty tracking inmates who leave, so it’s unclear how well they do on the outside. What’s more, inmates by this time face a daunting uphill trudge to sobriety, hampered by family dysfunction on the outside, shredded personal relationships, a private sector wary of hiring them, and on and on.

And of course, there isn’t nearly enough in available treatment options.

“I would love to shut some of these programs down,” Bolton said. “This shouldn’t be the jail’s responsibility. [Addiction] is a public health issue. Our job is detention, protection of the public, to get people to court. When we have to become the quasi mental health facility for people who are poor and don’t have access to services, or for people who are drug addicts and who’ve created these chaotic lifestyles for themselves and can’t get treatment in the community — then we become this de facto fallback place for everybody. That’s not what jails are designed to do, nor should they be.”

Yet until a massive investment in community drug rehab and medically assisted treatment takes place, it’s likely that pods like Enough is Enough will be necessary.

It also occurs to me that with jail rethought and remade — a nurturing place — we have the chance that it will be an asset in the next drug scourge that comes along.

Either way, as with Kenton County, it seems like a better bet of public money than the way jail has been done up to now.

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Filed under Dreamland, Drugs, The Heroin Heartland

The Sheriff and the Country Boy

I meet a lot of great folks as I talk about Dreamland across America – and hear amazing stories, too.

In Richmond, Virginia recently, where Virginia Commonwealth University had chosen Dreamland as the Common Read for their incoming freshmen, I happened to meet Sheriff Karl Leonard, of nearby Chesterfield County.

We got to talking about a recovery pod – which he calls the Heroin Addiction Recovery Program (HARP) – he instituted in his jail. HARP allows inmates to begin their recovery from addiction, with a nurturing, inmate-led environment. This replaces the stress and tedium of traditionally run jail.

Traditional jail has always been a prod to crime and drug addiction. But sheriffs like Karl Leonard are rethinking how it’s done. I find this transformation of jail, which is growing as a response to our opiate-addiction epidemic, to be one of the most radical and positive ideas happening in America today.

I wrote about another jail, in Kenton County, Kentucky, doing the same thing a while back.

Later, Sheriff Leonard sent me an email with the following story. Please read:

__________

I work very hard with our Heroin Addiction Recovery program (HARP) to educate the public and to break down the stigma that is attached to not only being an addict but a criminal as well. I take recovered addicts from our program out into the community all the time so they can put a face with this disease. And once I do that I have personalized this crisis with them and they can no longer look away. I have these addicts tell their stories which are always compelling and gut wrenching. But just when I think I have heard it all, I get educated myself.

Just a few weeks ago after one such public engagement in the community with two of the HARP members, one male and one female, I decided to take them to lunch at a local Burger King as a reward, which I do often. (They are placed in civilian clothes when we take them out of the jail).

When we pulled into the Burger King parking lot, the male asked me what this was. I was dumfounded by the question and told him it was Burger King. I then asked him if he’d ever been in a Burger King before, thinking he was messing with me. But he said no. I then asked him if he was ever in a McDonald’s before; he again said no.

I shrugged it off and took him inside. He spent several minutes looking at the menu above his head like a child on Christmas morning. He turned to me and asked me if he could get whatever he wanted. I said yes. He then asked me if he could get the biggest thing on the menu and I again said yes, knowing that jail food probably didn’t satisfy this 6’4”, strapping 26-year-old. He then ordered the mushroom Swiss triple burger and a large Coke and fries.

I watched him devour his meal. I asked him if he liked it and he replied he did very much, especially the Coke. I asked him if he had Coke before and he told me he had not. This kid who never had a Burger King or McDonald’s hamburger or a Coke is a heroin addict.

He told me he grew up in a very rural county in Virginia and his father was very strict with him about eating junk food, sugars, sodas, etc. His father made sure they only ate good fresh food without sugars. It is also why he led a life that was drug free – not even marijuana.

His father also helped him with his athletic skills, which helped him become a very good football player in high school. So good he was given a scholarship to play football at a prominent four-year university in our state. I was intrigued by how this seemingly innocent guy became a heroin addict.

Then the common thread to almost all of our heroin addicts revealed itself.

While at the university, he said, he was involved in a bad car crash and suffered a broken femur, shoulder, and other bones. Eventually his doctor gave him Oxycontin and Dilantin pills. He was directed to take four Oxycontin pills a day for 30 days in addition to the Dilantin.

Once the prescriptions ran out he said he started to become very sick but he didn’t know why. He spoke to a friend who told him he was in withdrawal from the painkillers, which was causing his sickness. So he went back to his doctor, who refused to prescribe him any more. He was very sick and tried to get pills on the street but they were hard to get and expensive so he turned to heroin. And that was all it took.

He eventually had bad drug screens at school and was kicked out of the university and lost his full scholarship. When his father found out he was using drugs he disowned him. So now, without a dorm room or family to take him in, he turned to criminal activity to sustain his life.

These stories go on and on. They are all heartbreaking but also examples of how these are not bad people trying to be good but sick people trying to get well. And we are making a difference here with our very unconventional approach to recovery.

Thank you for enlightening a Nation with your book!

Karl

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Filed under Dreamland, The Heroin Heartland

Why I Voted Against California’s Prop. 47

Last year, Californians were asked to approve Prop. 47, which made misdemeanors of several felonies.

The idea was to send fewer people to prison and a majority of Californians voters approved it. I wasn’t one of them.

I voted against Prop. 47 for exactly the reason mentioned in a recent op-ed piece in the LA Times: that addicts frequently need the threat of jail or prison to get their minds around the idea of entering rehab.

The threat of prison was, in other words, a rock bottom from which some could achieve recovery.

cropped-IMG_0910.jpgThis comes from interviews with many recovering addicts whose lives were saved by being arrested, by going to jail and facing prison time.

The idea that government or society should play no role in pushing addicts into recovery is foolish, dangerous, too. It does no one any good to remove that threat.

But that’s what Prop. 47 does, to the detriment of folks addicted to drugs, I believe.

The op-ed makes the point that it’s leading to an increase in crime. That may be true. But from my standpoint, having written Dreamland, and seeing widespread addiction to pain pills and now heroin across America, it is the former reasoning that makes most sense, particularly given how horrifying difficult it is for so many to kick their habits.

Prop. 47 couldn’t have come at a worse time. Addicts need any kind of impetus they can get. Unfortunately, for many in California, it no longer exists.

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Filed under California, Drugs, The Heroin Heartland, Writing

CALIFORNIA: Toothbrushes and solitary confinement

The other day, on my way out of town on vacation, I stopped by a San Bernardino County Courthouse to hear a bit of the trial of Richard Gatica.

Richard Gatica is accused of strangling his cellmate at West Valley Detention Center in Rancho Cucamonga in 2006. He then propped up the cellmate for more than a day, pretending to talk and play chess with the cellmate, and moving the corpse occasionally, so that jailers wouldn’t realize what had happened.

Gatica, who grew up in Rosemead, was already doing two life terms in prison when this happened. So prosecutors are asking for the death penalty.

I happened to catch the testimony of the psychiatrist, employed by the prison system, who examined Gatica for several hours and reviewed thousands of pages of documents about him, and concluded Gatica suffered from several kinds of mental illness.

The doctor described a childhood of apparently nonstop abuse by a sadistic mother who “was severely mentally ill, both because of addictions and because of an innate mental disease which appears to be major depression. … Mr. Gatica was, along with his younger brother, the focus of his mother’s illness and anger in that Mr. Gatica was physically and emotionally abused through much of his childhood.”

Among the mental illnesses Gatica developed was post-traumatic stress disorder.

The doctor went on to say that later, in the prison system, Gatica was incarcerated in a special housing unit, SHU, which amounts to solitary confinement, where inmates are denied human contact, often sunlight and are let out of a cell an hour a day. The SHU is reserved usually for inmates who’ve committed some crime in prison, or been part of a prison gang. Gatica lived in a SHU for a dozen years, the doctor said.

“He grew up without a father in the home and with a crazy abusive mother who was also a drug addict. There wasn’t much opportunity for Mr Gatica to learn coping skills, how to be a loving, caring person. What he learned was how to be a drug addict and a criminal. Being in the segregated housing unit only reinforced Mr Gatica’s dwelling in his internal world of disassociation and very pathological defense mechanisms.”

One of which, the doctor said, was to develop an extreme phobia to germs to the point where he would scrub his cell with a toothbrush “20 to 30 times a day or [wash] his hands 20 to 30 times a day.”

Gatica sat in his seat, dressed in a lavender shirt, a tie, black slacks, glasses, short, gelled hair — looking like a business executive and watching the very middle-class jury absorb all this.

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Filed under California, Gangs, Prison