An estimated 60% of jail inmates have a substance use disorder (SUD)1 and many of them will experience forced withdrawal following arrest and incarceration due to sudden discontinuation of the substance. At the Los Angeles County Twin Towers Correctional Facility, up to 70 people per day arrive in or at risk of withdrawal, with alcohol withdrawal resulting in 3 deaths in 2017. Untreated substance withdrawal, particularly from alcohol, opiates, and benzodiazepines, is a significant cause of early mortality and morbidity during incarceration. Jail intake represents a critical window for managing withdrawal and initiating comprehensive, patient-centered addiction treatment services which have been shown to promote successful reentry and sustained abstinence.

In order to improve quality of withdrawal care and long-term clinical patient outcomes, the Twin Towers Correctional Facility will implement a multi-strep triage to treatment pathway with a centralized detoxification unit and linkage to community resources prior to patient release. This pathway includes a standardized triage process to guide timely identification and treatment of patients who are actively withdrawing or at risk of withdrawal from alcohol, opiates, and benzodiazepines following arrest; an innovative, dedicated detoxification unit in which patients identified via the triage pathway can receive centralized, best-practice withdrawal care; and linkage to addiction services both during incarceration and following release.

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