Ingestion drug testing can save lives

From Spark Training, LLC.

Fatal drug overdose is the fastest growing cause of death in prisons, justifying the average amount of time served before a drug or alcohol-related death once. [1] Many of these overdoses are caused by people taking drugs during arrest, either to hide evidence or to get “one last hit” before being arrested. A person is not fit for incarceration if they go to prison and die of an overdose within 24 hours – but how can we know if they don't tell us when they come in? Facilities should work to identify and treat individuals with substance use problems before sending them to prison.

Contraband Control: Body Scanners and Immunity

Some prisons have tried to curb overdoses and smuggling by introducing body scanners or strip searches upon admission. Despite easy availability Grants and funding for body scannersHowever, some facilities remain reluctant to use body scanners because they are perceived to be problematic or require additional recording steps. [2] Many websites also have aborted strip searches out of fear of prosecution or because officials are uncomfortable carrying them out. [3]

To prevent substances from entering the prison, some prisons offer individuals immunity for possession before they enter the booking area. The deal is that a person can willingly surrender illegal substances before consumption without incurring additional fees. From that point on, however, they are charged with bringing contraband into prison. This strategy can deter people from using drugs to conceal evidence. However, the person who wants the final blow is probably not thinking about the charges if he or she uses drugs during the arrest. Ultimately, a person struggling with addiction may still attempt to conceal the drugs if it gives them the opportunity to use them while incarcerated.

Although this is a step in the right direction, even with body scanners and strip searches there is no way to determine how much of a substance has been ingested or whether intervention is appropriate in the event of an overdose. Reducing contraband helps prevent overdose after ingestion, but does little to provide immediate intervention. In those first critical hours, it can mean the difference between life and death.

Challenges with Screening: Self-reporting fails

People enter prison without health information, meaning correctional medical staff rely on self-reports and intake screening questions to determine whether a person is suitable for detention. If a person does not disclose or lies about substance use, treatment is impossible. There are few other options available to the medical team to connect a person to appropriate overdose, withdrawal, detoxification or addiction treatment.

Self-reporting is a notoriously unreliable method of determining past drug use because people are reluctant to report drug use due to stigma and fear of additional charges. Even in a survey in which participants were told that they would then take a drug test, more than half of the participants tested positive for cocaine or heroin lied about the use of the substances during admission screening. [4]

Drug Testing: A Life-Saving Tool

The UK has had drug testing upon arrest (DToA) since 2003. proven to reduce drug use and drug-related arrests. [5] As of 2021, over 90% of positive tests in the UK resulted in referrals for assessment to determine treatment. Of these recommendations more than half subsequently sought treatment. [6] In contrast to only 10% of people diagnosed with substance use disorders in U.S. state prisons received treatment in 2021. [7] This doesn’t even take into account the many incarcerated people with undiagnosed substance use problems.

The introduction of ingestion drug testing would allow for immediate intervention and targeted support based on the amount and type of substances found in the test. It is often a condition of bail to already submit to a drug test, however positive tests can lead to additional charges or probation/parole violations. These deterrents act as a barrier to people seeking help for addiction problems in prison. Similar to how contraband can be handed over before admission, drug testing can be carried out before booking to determine whether a person is suitable for accommodation or whether medical intervention is appropriate before travel continues.

For ingestion drug testing to be effective, there should be immunity to positive tests. The purpose of ingestion drug testing is to save lives by connecting people to treatment. Drug testing may be performed by a nurse at ingestion or pre-ingestion to determine appropriate care, and the result will be treated as protected health information (PHI) under HIPAA. However, this would not prevent the records against the individual from being subpoenaed, and additional legislation will be critical to ensure that appropriate immunity is provided to individuals seeking life-saving addiction services in prison.

References

1. Wang L. (2021.) The rise in prison deaths is particularly concerning as the prison population becomes increasingly rural and female. Prison policy initiative.

2. Police provide help. (2018.) How to Fund Drug Detection and Interdiction Equipment for Prisons and Jails. Corrections1.

3. Egan P. (2023.) Michigan prison officials protest new strip search policy for transgender inmates. Detroit Free Press.

4. Hunt D, et. al. (2015.) Telling the truth about drug use: How important is it? Journal of Drug Issues, 45(3), 314-329.

5. Department of Justice. (2017.) The Impact of Drug and Alcohol Treatment on Recidivism. Governor UK.

6. Home office. (2024.) Summary: Drug Testing on Arrest (DToA) Program. Governor UK.

7. Widra E. (2024.) Addicted to Punishment: Jails and prisons punish drug use far more than they treat it. Prison policy initiative.

About the author

Spark Training is a nationally recognized center of excellence that sets the standard for training and compliance through high-quality programs and quality improvement. Recently, the company was named Best Corrections Company 2024 – USA at Corporate Vision's sixth annual Education and Training Awards.