Colorado jails among those with opiate withdrawal deaths

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Within the past two years, at least a half dozen opiate withdrawal deaths have been recorded in jails nationwide. These deaths have attracted national attention for their brutality, as well as for their incongruousness: opioid withdrawal, while miserable, is rarely life-threatening if medication, monitoring and, in severe cases, intravenous fluids are available.

At least two of these deaths occurred in Colorado jails.

A 38-year-old mother of seven, Jennifer Lobato, was arrested in 2015 for shoplifting. Over the next 24 hours, multiple pleas for medical attention from Lobato and her neighboring inmates were repeatedly ignored by jail staff. Lobato later died from a heroin withdrawal.

In May of that year, Tyler Tabor, 25, suffered a similar fate. Three days after his admittance into the Adams County Detention Facility, Tabor passed away from dehydration — directly resulting from opiate and benzodiazepine withdrawal. Records show medical staff denied his request for an IV on the basis that it wasn’t medically necessary.

Advocates worry that the opiate epidemic will aggravate the problem.

“Obviously, this is an emerging, growing problem and it’s hitting communities all over the country. That’s exponentially so in jails,” said Emma Freudenberger, a civil rights lawyer working on a similar case in Pennsylvania. She believes that jails have a fundamental duty to care for their inmates, but wonders if some lack concern for people struggling with addiction.

David Lane, the civil rights lawyer who worked with the families of Lobato, Tabor and two other inmates to whom Colorado detention facilities denied adequate healthcare, sees a different problem.

In an interview with Westword, Lane said staff don’t care what happens to their prisoners.

“Any medical care is viewed as an unnecessary expense, and as a result, people are treated like animals,” he added.

Lane assisted Tabor’s bereft family in filing a lawsuit against Adams County and Corizon Health Inc, their healthcare management partner, this past June.

Her family thought jail would be a safe place to detox

In the days following her 18-year-old daughter’s first arrest on heroin charges, Stephanie Moyer took solace thinking the nearby jail in central Pennsylvania would be a safe place for her to stay until she could get her into a treatment program.

However, Victoria “Tori” Herr sounded disoriented on a call home three days later.

“I just want something to drink. I want lemonade. They won’t give me lemonade,” she told her mother, who asked what was wrong. “I don’t know, but I’m seeing people die. I’m going to die.”

“I said, ‘Well, maybe you’re going through withdrawal,'” Moyer recalled last week, more than a year after Herr collapsed following days of severe vomiting and diarrhea at the Lebanon County Correctional Facility.

Herr, who had told intake officers she’d been using 10 bags of heroin a day, never regained consciousness and was taken off life support at a hospital five days later.

“This is a woman who died because she was detoxing,” said Moyer’s lawyer, Jonathan Feinberg, who filed a federal civil rights lawsuit Monday in Philadelphia. “Had Tori Herr’s withdrawal been treated … she almost certainly would be alive today.”

“Opioids is one of the safer withdrawals.”

“Opioids is one of the safer withdrawals,” said Dr. Eke Kalu, general medical director for the Philadelphia Prison System, which is run by the prison medical contractor Corizon.

The city screens inmates using the Clinical Opiate Withdrawal Scale to assess their need for medication or IV fluids. Officials could not remember an opiate withdrawal death during that time.

Detainees at Rikers Island, in New York, also can get methadone maintenance, which some experts believe lowers the chance of relapsing upon release. But smaller jails may lack in-house medical units or sufficient monitoring. Prison advocates believe the lapses can amount to cruel and unusual punishment.

Herr was staggering by the time she was taken to the medical unit the last night at the jail, according to Moyer’s lawsuit. She was given water and Ensure, but resumed vomiting when she returned to her cell, the suit says. Severe dehydration brought on by constant vomiting and diarrhea can lead to delirium, an electrolyte imbalance and cardiac damage. Herr also went some time without oxygen after she collapsed, causing irreversible brain damage, the suit said.

“I’m not a professional, but, as a mother — Day 1 — I would have taken her to the hospital if I would have seen her vomiting or not keeping things down,” said Moyer, a graphic artist who raised her son and daughter on a quiet lane amid bucolic fields of corn and hay in Lebanon.

Warden Robert Karnes later told Moyer that his staff followed “all operational protocols” in treating her daughter, the lawsuit said.

Herr, a talented artist, graduated from high school in 2014 despite using heroin in the final months, something her mother attributes to her long struggle with anxiety. Moyer last saw her the day before her arrest, when she went to the apartment her daughter shared with a boyfriend to discuss an inpatient treatment program she had found.

“I told her that her name was Victoria and that’s close to ‘victorious,’ and I promised her she would be victorious in getting through it,” Moyer said. “She smiled and said, ‘That means a lot to me, Mama.'”

Freudenberger doesn’t expect jails to offer similar rehabilitation programs.

“But they had to do everything they could to keep her alive. If they couldn’t do that, they had to send her somewhere else. They couldn’t just let her die,” she said.

Multimedia business & healthcare reporter Chloe Aiello contributed to this report. She can be reached via email at caiello@denverite.com or twitter.com/chlobo_ilo.

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