Pain Management Rarely Means Opioids for San Diego Jail Inmates

Los Angeles Times

By Kristina Davis

It wasn’t long ago that a complaint of pain at a San Diego County jail easily scored an inmate a prescription for an opioid.

These days, the highly addictive, frequently abused painkillers have been largely swapped out for Tylenol and ibuprofen as part of a program to stem the cycle of opioid addiction behind bars.

So much so that an inmate with an opioid prescription is a rarity.

Last month, only 23 inmates, including those with cancer, were prescribed an opioid. That’s less than 1% of the total jail population.

The number represents a 98% drop from the beginning of 2013, when nearly 1,000 inmates were prescribed more than 77,000 narcotic painkiller pills.

“This really cleaned up the jails,” said Dr. Alfred Joshua, the Sheriff’s Department’s chief medical officer who implemented the program in 2014. Sheriff’s officials report fewer opioids being diverted to other inmates, fewer inmates being bullied for their prescription pills, fewer overdoses and an overall calmer environment in the daily medication lines.

“Any process that will help someone overcome addiction can only be viewed as successful,” said sheriff’s Cmdr. Mike Hernandez, who heads the medical services division.

However, authorities have noticed an uptick in attempts to smuggle heroin into the jails, a trend officials attribute only partly to the reduction in prescription opioids. Under the 2011 Public Safety Realignment law, some inmates are serving longer terms in jails rather than prisons — an average of 215 days — and are directing smuggling operations, Hernandez said.

“They’re mirroring what they do in state prison,” he said.

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