Is Jail the Safest Place for Him?

Fireweed3 recently saw a friend whose son uses fentanyl and heroin. Her friend could report him for outstanding warrants, but is it wise to land a Loved One in jail when you're worried for their safety?

I had coffee with a friend this morning — a mother of young adult son who uses fentanyl and heroin. Goes without saying, she is afraid for his life.

Some of her friends are encouraging her to report him for outstanding warrants. The thinking goes, if he's in jail, he can't use, and he can't die. But the downside is, by reporting him to authorities, she would risk breaking trust and damaging her relationship with him.
Moreover, he would have to detox in jail, and he would be at significantly higher risk of overdosing after being released. (His warrants are in a county north of here that does not provide naloxone upon release.)

When is it appropriate/wise to nudge someone to jail in an effort to save their lives? Can you point me to some information/resources that may help my friend weigh pros/cons?

As an aside, my daughter is still in treatment out of state, and is talking now about sober living. This is progress because last time she discharged from treatment, she wanted nothing to do with sober living. Still, I worry about the underlying eating disorder. I've noticed that she's losing weight. She tells me she "doesn't want to use again" so she's "not going to gain any weight." The clinic isn't able to provide evidence-based treatment for the ED. It's a huge concern. I'll post separately on this soon.

Thank you as always.

Your friend is thinking of turning in her son for outstanding warrants as a way to put him safely in jail. She is understandably very concerned about the opioids he is using.

Jail is part of the parade that unrolls in front of many of us. We have seen jail help by scaring a Loved One, or through programs located inside the jail. And, yes, the person going to jail will become free of drugs but the detoxification process can be long and very uncomfortable. This sort of detox is a violation of human rights in my estimation.

It’s a difficult decision to face: voluntarily choosing to have your son locked up as a way to protect him from the dangers of his drug use. I think Section 35 or outpatient medication treatment are better alternatives.

Families with addiction interact with jails. The criminal justice system is part of the environment with addiction. We have seen how a jail stay can scare a person, and otherwise alter motivation. It can be a safe place as compared to the streets. It is not where someone with addiction belongs, however.

I would much rather see your friend work the CRAFT program (it can take as little as 4 weeks to get a Loved One into treatment with CRAFT). I would suggest she locate the medication assisted treatment clinics as a first step. Getting her son on a medication such as Suboxone or Methadone is a much safer solution for her son, and more sound for the long-term. Remember that the research on CRAFT shows it outperforms interventions, which are 24% successful. Compare this to CRAFT which is 70% successful.

There is a new law in the state of Massachusetts that makes it mandatory this fall for jails to to continue people on medication for opioid disorder when they enter jail. So, no detoxifying for them. Your friend’s son is not on assisted medication. Some jails are going further and considering starting people on medication assisted treatment. The jail in Ludlow, where I work, has already started people on a medication right before release. We are considering how to start people on it during their stay in jail.

The treatment of people with addiction behind bars is getting a lot of attention. Still, I would rather see your friend try CRAFT and start first with community treatments like medication assisted treatment. The outstanding warrants are there, and he will bump into the police sooner or later. Section 35 isn’t a panacea but it is a relief for families. Medication, even if he isn’t ready to stop, can help him manage his use of opioids and relieve him of the terrifying withdrawals he is now forced to chase away everyday by using.

Families have intolerable choices to make in the face of addiction. I believe CRAFT is a much softer landing for everyone. Yet it is totally understandable that your friend would be grasping for anything to protect her son at this point. The families on this site know well the desperation felt when we feel unable to control a Loved One’s decisions and behaviors. But with this desperation we find ourselves in such a vicious cycle. The family member ends up so depleted, and very little is accomplished. Focusing on what she can and can’t control, learning a few new tools for communication, and grounding herself in this kind of supportive community could help her make those shifts that would ultimately foster more trust between her and her son. At least it could help shift her thinking about what is possible – knowing how to see and swiftly act on those windows of opportunity when her son is more receptive to treatment.

Your friend is navigating these monumental decisions with all the information she has. It’s true there are pros and cons with either choice. She has to go with what her heart tells her. But the more options she has to consider, the better. It’s good she has someone like you that she can trust, and with whom she can talk things through, painful as the topics are.

Thanks for your update about your daughter and the danger of an eating disorder. That must be hard to assess and process from afar, especially knowing that the clinic isn’t providing her with significant support for this. Let us know where she is/ where she is likely to end up in sober living so that we can help locate treatment options. These aren’t easy to find, especially when addiction and eating problems co-occur.

It’s really encouraging that she is actively considering sober living now. It sounds like she has learned more about herself, and realizes what kind of support she will need to succeed after this round of treatment. You’ve been doing such a beautiful job throughout this saga. We are here with you. And we are so heartened to hear of your daughter’s sobriety. Keep in touch and we’ll help find support for the eating disorder. Thanks for writing in.