What is the most common mistake made when treating withdrawal in a correctional facility?
Consider these two patients:
- A jail patient booked yesterday is referred to medical because of a history of drinking. He has a mild hand tremor and “the look” of a heavy drinker. But he says he feels fine and has no complaints. His blood pressure is 158/96 and his heart rate is 94.
- A newly booked jail patient says that she is going to go through heroin withdrawal. She is nauseated but still eating and has no gooseflesh or rhinorrhea. Her heart rate mildly elevated.
In many jails, neither of these patients would be started on treatment for withdrawal at their first visit to medical. But this would be a mistake! Both patients should be started on treatment for withdrawal immediately.
The most common mistake made when treating withdrawal in a jail is not to treat the withdrawal at all!
Both of these patients have the potential to slide downhill rapidly. And in both cases, the potential benefits of starting treatment far, far outweigh any potential liability.
Let’s look at these cases in more detail.Continue reading