Death by Withdrawal

Abstract

No one deserves to die just because they use drugs. Yet, policies and practices in jails and prisons around the country continue to facilitate the death, pain, and suffering of people who use drugs by refusing to properly screen and medically manage withdrawal for persons in custody.[1] In Estelle v. Gamble, the Supreme Court established a constitutional right for incarcerated persons to receive adequate medical care. Further, it prohibited the denial of medical care that causes “the unnecessary and wanton infliction of pain” and required the provision of adequate medical care to comport with evolving standards of decency. This article argues that the failure to medically manage withdrawals for those in jail and prison custody amounts to deliberate indifference to a serious medical need and, as such, constitutes a violation of Fourteenth and Eighth Amendment protections. To do so, this article presents a detailed explanation of the medical literature on evidence-based medical treatment for withdrawal syndrome, and demonstrates the different ways in which jails and prisons have ignored or failed to provide bare minimum evidence-based medical care. This article excerpts firsthand accounts of persons in withdrawal to demonstrate the level of “unnecessary and wanton infliction of pain” caused by such deliberate indifference and argues that evolving standards of decency require the reformation of current inhumane practices.


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[1]. Managing Substance Withdrawal in Jails: A Legal Brief, Bureau of Just. Assistance 2 (2022), https://bja.ojp.gov/doc/managing-substance-withdrawal-in-jails.pdf [hereinafter BJA].

Keywords: civil rights, addiction, constitutional law, eighth amendment, fourteenth amendment, jails, prisons,