Opioid Detoxification Guideline
Acute opioid withdrawal is common upon entry into correctional facilities and, untreated, may result in needless suffering, interruption of life-sustaining medical treatments and, rarely, death. National research show significant gaps in quality of care for opioid withdrawal in correctional institutions, including underuse of recommended protocols and low use of drugs approved for detoxification by the Food and Drug Administration. To improve success in reducing substance abuse during and after correctional confinement, the National Commission on Correctional Health Care has issued a new guideline on opioid detoxification in correctional settings.
The general approach to opioid withdrawal comprises four essential components:
- Screening. All inmates should be screened for potential opioid withdrawal symptoms within two hours following entry into the facility.
- Evaluation. All inmates who screen positive should be formally assessed for opioid withdrawal within 24 hours.
- Detoxification. All inmates with clinically significant withdrawal should be treated with effective medication.
- Referral for substance abuse treatment. All inmates with opioid withdrawal should be educated about their disease and referred for substance abuse evaluation and treatment.
Detoxification does not treat the underlying disease of addiction. All inmates with opioid dependence should be referred for substance abuse treatment. Depending on expected time of confinement, the inmate should be offered enrollment in drug treatments programs within the facility or referred upon release to comprehensive treatment programs that offer both behavioral and pharmacological treatment. Engagement in community treatment should be done quickly because correctional release often triggers relapse with a high risk of overdose and death.