EVERETT — Heroin use is so rampant among people being booked into the Snohomish County Jail that Monday, more than 90 percent of the 52 inmates locked up in the medical unit were dangerously ill with withdrawal symptoms.
The jail’s medical unit was designed to hold 24 inmates, and until recent years, it typically operated at about two-thirds capacity.
So far this year, it is averaging more than 44 inmates daily. Much of that increase has come since 2013.
The biggest health issue is detainees addicted to heroin or other opiates, according to a new report prepared by the corrections bureau of the Snohomish County Sheriff’s Office, which operates the lockup in Everett.
“Heroin has caused the jail to become Snohomish County’s largest ‘de facto’ detox center over the last two years,” corrections Maj. Jamie Kane wrote.
The report was presented Monday to the County Council’s law and justice committee. It describes the challenges the county faces in detaining and keeping safe a growing number of dope-sick inmates.
People withdrawing from heroin and other opiates require close monitoring by nurses and corrections officers. They are at risk of life-threatening dehydration, and some can become so miserable during withdrawal that they are willing to harm themselves in hopes of getting access to pain medication.
“Common methods used by inmates in the past were to jump off the upper tier or fall down stairs in a ‘general housing’ unit to cause injury to themselves,” the report said.
To lessen that risk, fencing was installed on the upper tier of a unit that now is used for overflow when the number of inmates undergoing opiate withdrawal leaves the jail with few options.
Safely housing detoxing inmates requires extra staffing, according to the report. Up to 25 staff, including corrections officers and nurses, are required to monitor detainees going through opiate withdrawal.
“Law enforcement is being used as a catchall solution,” Sheriff Ty Trenary said. “The heroin epidemic is not just a law enforcement problem. We’re a tool in the solution.”
More community resources are needed, the sheriff said.
There is only one 16-bed publicly funded detox facility in Snohomish County. Roughly 70 percent of those admitted to Evergreen Manor report that heroin is their drug of choice. The county is hoping to open a second detox facility by next year to meet the demand.
When Trenary was appointed sheriff in July 2013, the jail was struggling with a string of inmate deaths.
Most of the 13 deaths since 2010 were among people with serious health problems, often linked to longtime abuse of drugs and alcohol, records show. The death rate was typical of what is seen at similar-sized lockups around the country, according to a federal Department of Justice statistician who tracks inmate deaths.
At the sheriff’s request, federal corrections experts conducted a review. Among other things, they recommended upgrades in the jail’s ability to identify and address health issues among detainees.
The changes appear to be producing results. An airport-style body scanner now is used during bookings to better detect drugs that people are trying to sneak inside. All inmates undergo health screening before booking.
The sheriff’s office partnered with the county’s Human Services Division to put someone in the jail to enroll detainees into Washington Apple Health, the state’s Medicaid program. That means once people are released from jail they can access medical services, such as chemical dependency treatment or mental health resources. The county is monitoring whether this move will reduce people revolving in and out of jail.
Trenary also imposed restrictions on bookings, including a policy enacted in July 2014 that turns away people being held on nonviolent misdemeanors if jail medical staff determine the detainee is a withdrawal risk during custody. The daily average population at the jail is now about 1,000 inmates.
The new restrictions on average have been reducing the jail population by about 100 bookings per month. If it were not in place, there likely would be roughly 10 more inmates per day undergoing heroin withdrawal at the jail, Kane said in the report.
People at the jail understand that not booking people has consequences — for the community and for those who need help addressing their drug use.
“The majority of bookings turned away are for petty crimes, such as illegal camping, shoplift, trespass and theft,” Kane wrote. “These are typically committed to help feed a drug habit or due to homelessness caused by addiction. Returning these criminals to the street increases the risk to our community and perpetuates this negative cycle.”
The sheriff’s office decided to prepare the report and make a presentation to the County Council as part of what it hopes will be an ongoing discussion about the work it faces.
“There are a lot of sick people who don’t belong in jail. We don’t have enough detox and mental health facilities. Those places will get them the treatment they need. The jail wasn’t designed to do that,” Bureau Chief Tony Aston said. “It’s important the community knows what’s really going on.”