The Justice Department’s Bureau of Justice Assistance (BJA), one of six program offices within the Office of Justice Programs (OJP), and the National Institute of Corrections (NIC) today announced the release of Guidelines for Managing Substance Withdrawal in Jails: A Tool for Local Government Officials, Jail Administrators, Correctional Officers and Health Care Professionals. This groundbreaking document supports the department’s commitment to increasing access to evidence-based treatment for individuals with substance use disorders (SUD) and those at risk for overdose, including individuals who are incarcerated or reentering their communities.
“These guidelines are a critical and much needed resource to support local government officials, jail administrators, correctional officers and health care professionals faced with the difficult task of managing substance withdrawal in jail settings,” said Associate Attorney General Vanita Gupta. “Providing this new, evidence-based tool and treatment guidance, developed by a committee of clinical and correctional experts, will better safeguard the health and well-being of individuals at risk for or experiencing substance withdrawal in jails.”
The high prevalence of SUD among individuals in jail is well-known, both empirically and anecdotally. The number of those in jail who died from drug or alcohol intoxication increased nearly 400% from 2000 to 2019. Less often recognized, but also potentially fatal, is the risk of substance withdrawal complications, such as profound dehydration and aspiration pneumonia due to severe vomiting.
“Jails face a unique and serious challenge managing substance use withdrawal among individuals in their custody, resulting in increased risk of in-custody deaths,” said OJP Assistant Attorney General Amy L. Solomon. “These guidelines, developed by a committee of experts representing correctional and medical professionals, offer concrete and evidence-based guidance to help jail administrators protect the health and rights of people in their care.”
“For many, incarceration is the first opportunity for substance use disorder diagnosis and treatment. Guidelines for Managing Substance Withdrawal in Jails can help jails of all sizes safely manage or prevent withdrawal, which may very well be the first step toward a person’s recovery from a substance use disorder and help avoid a return to incarceration,” said BJA Director Karhlton F. Moore.
“These guidelines are an important tool for corrections and health care staff who often face life-saving situations in their daily work life,” said NIC Acting Director Dr. Alix McLearen. “As a clinician myself, I know the value of services grounded in evidence, and I am thrilled these guidelines are now available to help providers safeguard the well-being of individuals in custody.”
An expert committee of clinicians and jail administrators compiled recommendations, grounded in evidence-based practice, for systematically identifying individuals who are at risk for withdrawal and determining the appropriate level of monitoring and medical care.
“As a member of the expert committee, I can attest to the rigor of the process for developing the guidelines,” said Chief Medical Advisor Dr. Marc Stern of the National Sheriffs’ Association and the American Jail Association. “We recognized, from our collective years of experience, that implementing withdrawal management cannot be a solo effort by jails. Successful implementation of the guidelines requires community involvement, such as establishing partnerships with hospitals and opioid treatment providers.”
BJA and NIC are offering technical assistance and training through Comprehensive Opioid, Stimulant and Substance Abuse Program website to support efforts to implement the guidelines. This webpage serves as a central hub to find relevant resources, submit questions and request TTA tailored to meet individual needs.