Advocates fear more heroin withdrawal deaths in jails

LEBANON, Pa. -- In the days following her 18-year-old daughter's arrest on heroin charges, Stephanie Moyer took solace in thinking she would be safe in jail until she got into a treatment program.

However, Victoria "Tori" Herr sounded disoriented on a call home three days later. She feared she was dying and complained of being thirsty, her mother said.

Herr, who had a 10-bag-a-day habit, collapsed following days of severe vomiting and diarrhea at the Lebanon County Correctional Facility.

She spent five days in the hospital, then died on Easter Sunday 2015.

Her case is one of at least a half-dozen deaths nationwide during the last two years involving jail heroin withdrawal, and advocates fear the number will grow given the nation's heroin crisis.

Advocates find the deaths particularly troubling because opioid withdrawal, while miserable, is rarely life-threatening if medication, monitoring and intravenous fluids are available.

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

Warden Robert Karnes told Moyer his staff followed "all operational protocols," the lawsuit states.

Jail and county officials didn't return calls Monday seeking comment.

"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 co-counsel on the lawsuit.

Other withdrawal deaths have been reported at jails around the country:

• In Oregon, a 26-year-old woman wrote increasingly dire notes to jail staff begging for help before she died after six days behind bars in 2014, The Oregonian reported.
• Near Detroit, a 32-year-old man lost 50 pounds during a monthlong stay in 2014 as he struggled to withdraw from methadone, opioids and the anti-anxiety drug benzodiazepine. A jail video shows him lying naked on a stone floor during what his family's lawsuit called his slow, painful death.
• In Colorado, a 25-year-old man died last year after he was prescribed a mixture of drugs to treat his withdrawal symptoms but never received them, according to his family's lawsuit.

Dr. Eke Kalu, the general medical director of the Philadelphia prison system, said quitting heroin is one of the "safer withdrawals" compared with alcohol and some other drugs.

The city screens inmates to assess their need for medication or IV fluids. Officials couldn't remember an opiate withdrawal death in the past decade.

Officials at Rikers Island, in New York, long have run a methadone maintenance program, which experts believe can help detainees kick their habit and lower the risk of relapse.

But smaller jails may lack in-house medical units or sufficient monitoring. Advocates say that can amount to cruel and unusual punishment.

Herr was staggering by the time she was taken to the medical unit, according to Moyer's lawsuit. She was given water and Ensure but resumed vomiting when she returned to her cell, the lawsuit stated. Herr also went without oxygen after she collapsed, the suit stated.