On the front lines: Law enforcement, jails adapt to opioid epidemic

Sep. 23—John Tharp's firsthand experience with the opioid epidemic started when he became sheriff of Lucas County, Ohio, about eight years ago.

Now retired, Tharp made it a point to ride with the row patrols and stop by the county jail during midnight shift to visit the officers on-duty, and he often saw recent arrestees going through drug and alcohol withdrawal.

One night, Tharp saw a clean-cut man in his 30s vomiting, screaming, urinating and flailing his arms and legs. The man even accidentally kicked one of the corrections officers but immediately apologized, which showed that the man had no control over his actions, Tharp said.

"He needed another hit of heroin, and I thought, 'this is going on so much,' and it appeared that these people were ill. They had a disease."

Deputies in the northwestern Ohio county confirmed that they likewise encountered similar cases of overdoses or withdrawals. Tharp also found that people often called EMTs and firefighters instead of police, and family members would give descriptions such as "my son fell down the stairs" or "my daughter can't breathe" to avoid admitting drug use to law enforcement, he said.

The experience convinced Tharp that it would take more than arrests or incarcerations to deal with the opioid crisis. With that understanding, he started Lucas County's Drug Abuse Response Team, or DART, in 2014.

DART is one way that law enforcement is responding to the opioid crisis, which killed 5,572 people last year in Pennsylvania, a 16% increase from the previous year. Often, jails, police and sheriff's deputies are first contacts for addicts in the throes of overdose and addiction.

Rapid response

Though Mercer County doesn't have its own DART-style program, Erna Craig, warden at Mercer County Jail, said the jail has adapted to issues stemming from multiple kinds of addiction, including opioid abuse.

The prison usually has about 1,800 commitments a year, and 90 percent of those individuals are involved with drugs, either through addiction or related crimes, Craig said.

Since the jail is often a first stop for suspects after they're arrested, some defendants arrive still under the influence. For that reason, defendants tend to be self-reporting during processing, which is followed by a detoxification period of seven to 10 days.

During that detox period, patients are kept in a special needs unit where jail staff can closely monitor the person in case of seizures or if the withdrawals take a turn for the worst.

"They describe it as being very, very sick, needing a lot of family-friend connection, doing a lot of sleeping," Craig said. "But once they're through it, they feel like a different person."

Since the average defendant is at the county jail for only about 16 days, Craig said it can be difficult to get long-term treatment programs for inmates. State prisons, where inmates are incarcerated in Pennsylvania for a minimum of two years, have more opportunities for long-term treatment.

Because Mercer County Jail often has addicts for such a short time, it has to offer rapid responses. That includes educational programs for defendants regarding drug abuse. Defendants are particularly warned against returning to their old habits, or at least urged to avoid resuming substance abuse after their incarceration.

"One of the saddest things that I see here is when we get someone detoxed and they're doing very well, they're very healthy, but they forget when they first came in, they may have been using very heavily and after they're released they take that fatal dose," Craig said.

The jail also offers vivitrol, which can be used to treat addiction.

Defendants receive a first vivitrol treatment at the jail, where jail staff can monitor the defendant to ensure there are no ill side-effects. The defendants then sign up for an agreement with either their parole officer or the courts to continue the vivitrol program after their release. Those treatments can be dispensed at at locations including the Mercer County Behavioral Health Commission, Craig said.

"We initiate the program for them, so when they leave we want to make sure they complete the program," Craig said.

Treatment success

Tharp, the retired Ohio sheriff, said DART has the same goal, as part of a more long-term process.

Over time, the DART program eventually became an independent non-profit entity, with Tharp serving as board chairman. DART also expanded to include educational outreach bringing together different elements of the community, and deputized officers from other law enforcement agencies in Lucas County as DART officers.

Sheriff's offices in other counties have also started similar programs, under "DART" and different names, Tharp said.

"It's like cancer or any other disease that you may have, and it's got to be treated like a disease," Tharp said. "Those individuals that are selling and pushing drugs, they need to be arrested, but it's not just one way of thinking."

As a first step, Tharp spoke with fire chiefs and EMTs and made sure that overdose patients were taken to the local hospital's emergency room. Then, the sheriff's department made arrangements with hospital officials to allow plainclothes DART officers to visit overdose patients in the emergency room.

Officers would then get patients admitted into a recovery program.

However, the officers were more than just chauffeurs — if the area recovery programs didn't immediately have a bed available, officers would spend time with patients while they waited, getting to know them or taking them for errands, or to get a bite to eat.

The officers worked with their clients for up to two years during the recovery process, building personal relationships over time.

The DART team achieved a success rate of more than 80 percent. Even in those cases where people relapsed during recovery, Tharp said the officers did not give up on their clients.

"We took an oath to protect and serve, and we have to remember to protect the weak," Tharp said. "People who are addicted and have this disease, they're human beings too and they need help.

"Downtime is the devil's workshop, and part of recovery is staying busy, staying active, and being focused on conversations, so with the COVID pandemic, that kind of fell off," Tharp said.

Like David L. Dye on Facebook or email him at ddye@sharonherald.com.