Thousands of people are booked into jails every day. Of them, more than 60% meet the criteria for substance use disorder. That means a significant number of people arrive at the jail in the early stages of withdrawal and with serious medical needs. Without prompt substance use disorder treatment, withdrawal can escalate quickly from deeply uncomfortable to even life-threatening.
What Is Withdrawal?
Withdrawal is the physical and psychological symptoms that occur when a person whose body and mind have developed a dependence on a substance suddenly stops using it or significantly reduces their intake.
What withdrawal entails depends on:
- The type of substance(s) used
- Duration of use, with the longer the dependence, the more severe the withdrawal
- Amount and frequency of use
- Method of use (injected, smoked, snorted, oral)
- Age, with older people typically experiencing more severe withdrawal
- Overall physical health and any pre-existing medical conditions
- Mental health history, including dual diagnosis
- Access to medical care and monitoring
- Stress levels — incarceration itself can worsen symptoms
- Social support (or lack thereof) during the withdrawal process
The combination of these factors can make withdrawal extremely uncomfortable and, if not properly managed, potentially life-threatening.
Withdrawal symptoms may include:
- Muscle aches, cramps, and tremors
- Nausea, vomiting, and diarrhea
- Sweating, fever, and chills
- Runny nose and watery eyes
- Insomnia, restlessness, or extreme fatigue
- Rapid heart rate and elevated blood pressure
- Headache and sensitivity to light and sound
- Anxiety, agitation, confusion, paranoia, difficulty concentrating, or panic attacks
- Hallucinations (visual, auditory, or tactile)
- Seizures
- Delirium tremens, which is severe confusion, rapid heart rate, and dangerous fluctuations in blood pressure
- Suicidal ideation
Evidence-Based Approaches to Treating Withdrawal in Jail
Effectively managing withdrawal in jail requires more than monitoring symptoms and waiting for them to end. Best practices call for a structured, medically supervised approach that begins at intake.
Intake Assessment
The foundation of any effective withdrawal management program is early identification. Two clinically validated screening tools are the standard of care: the Clinical Institute Withdrawal Assessment for Alcohol (CIWA) and the Clinical Opiate Withdrawal Scale (COWS). These tools are used during a patient’s intake assessment to help medical staff evaluate the severity of withdrawal symptoms, establish a baseline, and determine the appropriate level of care.
Medication-Assisted Treatment (MAT)
Medication-Assisted Treatment is widely recognized in the medical community as the gold standard for treating opioid and alcohol use disorders, and it is equally critical in managing withdrawal.
The three FDA-approved medications for opioid use disorder — methadone, buprenorphine (Suboxone), and naltrexone — work by reducing cravings, easing withdrawal symptoms, and stabilizing patients so they can engage in other aspects of treatment.
For alcohol withdrawal, medications such as benzodiazepines, phenobarbital, and naltrexone are used to prevent potentially dangerous complications, including seizures and delirium tremens.
These medications are clinically proven to save lives, reduce illicit drug use, and improve long-term recovery outcomes.
Continuity of Care
Substance use treatment isn’t a one-and-done proposition. Patients must be willing to continue their path to recovery once they leave the jail. It’s ideal if the healthcare team can work toward discharge planning that continues the treatment process. In the best cases, the patient should leave the jail understanding their treatment plan, with access to ongoing medication, and a referral for further treatment outside of the jail.
How TK Health Supports Withdrawal Treatment in Correctional Facilities
Delivering consistent, evidence-based withdrawal care in jails is no small feat. It requires the right clinical protocols, trained staff, reliable infrastructure, and a healthcare partner that understands the unique demands of working inside a jail. That’s exactly what TK Health was built to do.
Professional Understanding
TK Health specializes exclusively in correctional healthcare, which means we don’t apply a one-size-fits-all clinical model designed for hospitals or outpatient clinics and hope it translates.
We understand the operational realities of correctional facilities. In fact, even our top leadership has experience working in jails. So, we design our programs to work within jails, not around them.
When it comes to withdrawal, that contextual expertise makes all the difference.
Comprehensive Intake Screening
TK Health implements structured medical screening at presentation after booking, using validated tools like CIWA and COWS to identify people at risk for withdrawal. Early identification of withdrawal is essential to effective treatment and positive outcomes, so the sooner we can identify that a patient is likely to experience withdrawal, the better.
Medication-Assisted Treatment
TK Health supports the full continuum of medication-assisted services. We work with facility administrators to build programs that are clinically sound, operationally feasible, and compliant with current legal and accreditation standards. For facilities that are new to MAT, we provide the guidance, training, and clinical oversight needed to implement these programs with confidence.
Staff Training and Education
To an untrained eye, withdrawal can look like a refusal to comply. And patients aren’t always up front about what substances they’ve used or for how long. TK Health provides training and education to ensure our professionals and partners recognize the warning signs of withdrawal and respond appropriately.
Discharge Planning
People often move in and out of jails quickly, but we know successful withdrawal treatment shouldn’t end with a patient’s release. That’s why we do our best to ensure patients understand their treatment plans and what next steps to take when they leave the jail. While we can’t force anyone to continue in recovery, we can do our best to lower the barriers to treatment, even after incarceration.
Treating Withdrawal in Jail
Withdrawal can be a serious medical issue. That’s why it’s important to identify that a patient is experiencing withdrawal and begin treatment as quickly as possible.
At TK Health, we’re committed to ensuring that our patients withdraw safely and with as little discomfort as possible. Equally important, we want every patient to understand why withdrawal treatment is essential during their time in custody and after.
Put simply, we recognize that the withdrawal treatment we start during custody is a person’s chance for change and the better future they deserve.
