
Detox & Withdrawal Deaths
Alcohol and opioid withdrawal can be fatal without proper medical supervision. When jails treat withdrawal as a disciplinary matter instead of a medical emergency, people die.
Key Takeaways
- Alcohol withdrawal kills: Delirium tremens has up to 37% mortality without treatment
- Medical supervision is required: Jails must provide adequate detox care
- Symptoms are obvious: Seizures, tremors, confusion are unmistakable warning signs
- 2-year deadline: Oklahoma Section 1983 claims must be filed within 2 years
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Why Withdrawal in Custody Is Deadly
People entering jail often have active substance dependencies. Sudden cessation without medical support triggers dangerous physiological responses:
Autonomic Instability
Blood pressure, heart rate, and temperature fluctuate dangerously. Cardiovascular collapse can occur without warning.
Seizures
Alcohol and benzodiazepine withdrawal commonly cause seizures. Without treatment, status epilepticus can be fatal.
Delirium Tremens
Severe alcohol withdrawal causes hallucinations, confusion, and agitation. DTs require ICU-level care and has high mortality.
Dehydration
Vomiting and diarrhea lead to severe dehydration and electrolyte imbalances. Without IV fluids, cardiac arrhythmias develop.
Alcohol Withdrawal: A Medical Emergency
Alcohol withdrawal is one of the most dangerous substance withdrawals and can progress rapidly. Here's the typical timeline:
Early Symptoms
Tremors, anxiety, headache, nausea, insomnia. Many jails ignore these as 'minor' symptoms.
Hallucinations
Visual, auditory, or tactile hallucinations. Patient may be misdiagnosed as having psychiatric crisis.
Seizures
Generalized tonic-clonic seizures. Without treatment, can progress to status epilepticus and death.
Delirium Tremens
Severe confusion, fever, tachycardia, hypertension. Up to 37% mortality without ICU treatment.
Standard of Care
Medical standard of care requires: CIWA scoring every 4-8 hours, benzodiazepine administration based on symptom severity, vital sign monitoring, IV fluids for dehydration, and transfer to hospital for severe withdrawal. Many Oklahoma jails lack the staffing and protocols to provide this standard.
Opioid Withdrawal: When Jails Deny Treatment
While opioid withdrawal is rarely directly fatal, it can lead to death through dehydration, aspiration, and—most commonly—relapse after release. Recent legal developments are expanding jail liability:
Medication-Assisted Treatment (MAT)
Courts have found that denying MAT (methadone, buprenorphine) to inmates with opioid use disorder may violate the ADA and Constitution. Several jails have been sued successfully for discontinuing inmates' prescribed MAT.
Dehydration Deaths
Severe vomiting and diarrhea during opioid withdrawal can cause fatal dehydration if inmates are not monitored and provided IV fluids. Jails often fail to recognize the severity.
Aspiration Pneumonia
Vomiting while lethargic or impaired can lead to aspiration pneumonia and death. Proper positioning and monitoring are critical but often absent.
Legal Standard: Deliberate Indifference
To prove deliberate indifference to serious medical needs, we must show:
Objectively Serious Need
Alcohol and opioid withdrawal are recognized as objectively serious medical conditions requiring treatment. This element is easily met.
Subjective Knowledge
Officials knew of the risk and disregarded it. Evidence includes: intake screening, obvious intoxication at booking, statements about substance use, visible withdrawal symptoms, and staff training on recognizing withdrawal.
| Case | Holding |
|---|---|
| Estate of Clark v. Walker | Failure to monitor and treat alcohol withdrawal symptoms constituted deliberate indifference. |
| Pesce v. Coppinger | Jail officials liable for death from opioid withdrawal when they knew of addiction and failed to provide care. |
| Smith v. Carpenter | Denying MAT to inmate with opioid use disorder violated ADA and Eighth Amendment. |
Evidence We Gather
Medical Records
- • Intake screening forms
- • CIWA/COWS scoring sheets
- • Medication logs
- • Sick call requests
Video Evidence
- • Booking video (intoxication)
- • Cell surveillance footage
- • Medical unit cameras
- • Welfare check footage
Policies & Training
- • Detox protocols (if any)
- • Staff training records
- • Healthcare contracts
- • Prior incidents/deaths
Damages in Withdrawal Death Cases
Compensatory Damages
- Funeral and burial expenses
- Pre-death pain and suffering
- Loss of companionship
- Loss of financial support
Additional Recovery
- Punitive damages (individual officials)
- Municipal/private contractor liability
- Attorney's fees (Section 1988)
Pre-Death Pain & Suffering
Withdrawal is agonizing. The hours or days your loved one spent suffering without proper medical care—experiencing tremors, hallucinations, seizures, or severe dehydration—are compensable. These "survival action" damages can be significant.
Frequently Asked Questions
Your Family Deserves Answers
If your loved one died from untreated withdrawal in an Oklahoma jail, we can help you understand what happened and hold officials accountable.
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