Survey finds 'epidemic' of addicted inmates

The inmates shiver at the medical screening station, sweat coating clammy skin. Then the dizziness and nausea hit.

That's when nurse Jessica McCray knows the person just booked into Orient Road Jail is in the early stages of withdrawal from prescription painkillers.

"Usually, they've taken it in the last eight hours," McCray said. "A lot of them are concerned about withdrawal. They're going to be hurting."

Jail cells are no barriers against the prescription pill problem plaguing society.

Thirty-one percent of inmates in Hillsborough County jails said they took pills within a week of their most recent arrest. Fifty-three percent of inmates said oxycodone, Oxycontin or Roxicodone was their drug of choice.

The data is based on an informal survey of 438 inmates conducted last month at the behest of Sheriff David Gee, who wanted to know how prevalent the problem is, said Col. Jim Previtera, the director of county jails.

The jail population is about 3,000.

"The jail is a microcosm of the community," Previtera said. "Until it's controlled in the community, we have to deal with the aftermath."

The number of inmates addicted to opiate-based medication such as oxycodone or hydrocodone has risen in the past five years, said Beth Weaver, medical adviser for the sheriff's office.

The rise mirrors what is happening outside the jail walls, with Florida gaining a reputation as the epicenter of prescription pill abuse.

About 36 percent of inmates are arrested for the possession or abuse of painkillers, according to the survey. Fifty-one percent of those who were arrested had gone through withdrawal during their current sentence or a previous one.

"This is starting to have a serious impact on the jail and the inmate population," Previtera said.

Taxpayers are also affected. Detoxification and treatment programs for inmates add to medical costs, Previtera said, and detention deputies have to be trained to recognize and handle pill addicts.

Prescription pill abuse has caught the attention of state lawmakers who say Tampa and parts of South Florida are hubs for "pill mills," illicit pain-management clinics that dole out massive prescriptions.

Visitors from other states were known to travel to Florida to buy pills because of lax regulations, then return home to sell them at higher prices.

Florida has since passed tougher laws regulating the ownership and operation of pain-management clinics. When the law went into effect July 1, state law enforcement agencies conducted a regulatory check of such clinics.

More than 100,000 narcotic-grade pills across the state were seized, voluntarily surrendered or returned to the distributor. In Tampa, 4,698 pills were seized; in South Florida, 48,406 pills were rounded up from 14 locations.

Ninety-eight of the nation's top 100 oxycodone-purchasing physicians are in Florida, Gov. Rick Scott said when he signed the bill June 3.

The new laws establish standards of care for doctors who prescribe narcotic-grade pills, requiring them to register with the state Department of Health, and bans doctors from dispensing the most abused narcotics. Penalties against doctors who overprescribe pills have been toughened, with a minimum $10,000 fine and six-month suspension.

The legislation also establishes the creation of a prescription-drug monitoring database. The system, expected to go online by Oct. 1, will track where and how often opiate-based medication is prescribed.

Previtera said it's too early to tell whether these measures will curb the jails' prescription pill problem. Another survey of inmates will be conducted in the fall to see whether the new laws have had any effect.

"The jail can't bear the weight of this problem on our own," he said. "It wasn't designed to handle this epidemic. The best we can do is manage it."

The first step usually involves inmates going through a detoxification program. Weaver, the sheriff's medical adviser, said withdrawal symptoms can arise in eight to 72 hours, depending on the medication.

McCray, the nurse, said it can be difficult seeing people go through the pain.

"It's my job, but sometimes it kind of pulls at your heartstrings," she said.

Symptoms range from profuse sweating, nausea, vomiting, to tremors and a decrease in appetite.

"It makes you feel you're going to die," said John Maslanka, a drug abuse counselor for the county's jails. "You can't think of anything except using that drug again."

Inmates are given medical kits that target the symptoms of withdrawal to ease the discomfort, Weaver said.

There is only one long-term treatment option in jail, an eight-week counseling program primarily for addicts ordered by the court. There are only a few spots available for inmates who want to voluntarily sign up for the program, Previtera said.

About a dozen inmates participate in each eight-week session. The treatment program is no guarantee that clients can conquer their addiction.

"Some people are just so broken," drug counselor Gretchen Sanchez said. "It takes a lot to put them together."

Previtera said the jail can be like a revolving door for pill addicts, and the problem can't be solved until unscrupulous doctors prescribing the drugs are put in check.

"It will take intense rehabilitation and aftercare" to help inmates after they are out of jail, Previtera said.

A release from jail can compound problems and lead to relapses, Maslanka said. Most former inmates can't find jobs or afford treatment at private facilities, so they fall back into old habits.

"Hopefully, they get help," Maslanka said. "It hurts when you hear that people aren't doing well."

Shannon Collins completed the jail's counseling program in January, after she violated probation for possession of a controlled substance. Collins, 39, said she became hooked on painkillers after she injured her back in a car crash about eight years ago.

The addiction caused her to lose her job and family. Collins said she was high when she signed documents allowing her ex-husband to have custody of their son.

"I allowed it to ruin my life," she said. "The addiction to pills led to heroin. You get to the point when 200 pills a month aren't enough."

Counseling from Sanchez has helped Collins learn how to keep temptation in check. She's out of jail and enrolled in a long-term treatment program. She's interviewing for jobs and trying to get her life on track.

"I want to stay sober," Collins said. "I want a different life."