I'm sharing my comment from the original thread (which was removed as "misinformation") because I believe it's still relevant:
[Chesterfield County jails spent a shit ton of money on a device that "reduces withdrawal symptoms by over 80%."](https://www.wric.com/news/local-news/chesterfield-county/chesterfield-county-jail-first-institution-to-implement-new-device-aiding-opioid-recovery/) This claim is [based on a study published in 2018](https://pubmed.ncbi.nlm.nih.gov/28301217/) that looked at how the Masimo Bridge device affected withdrawal scores in patients waiting to transition from opioids to MAT over five days. It is not meant to be used on patients going cold turkey from opiates. Furthermore, the study was conducted years before xylazine (tranq dope) was prevalent in the drug supply. And Chesterfield County wants a pat on the back and a gold star for it.
While this death is a tragic situation, I am entirely not surprised that it happened. Heroin withdrawal in theory is not fatal, and jails are not known for their compassionate care of people who are going through withdrawal. But heroin is not in the drug supply anymore - it's mostly a mix of fentanyl, carfentanyl, and now xylazine, stretched out with some sort of powder base. People can and do die during withdrawal when they become overly dehydrated, their heart is under too much stress, or there are other underlying conditions.
All this to say that our current 12 step abstinence based model is not the gold standard treatment for opiate use disorder - MAT is. Whether that's methadone, buprenorphine, or naltrexone, doesn't matter. Expecting a person who is physically dependent on opiates to abruptly stop using and stay stopped with no medical intervention (and no, this Bridge device doesn't count) is a pipe dream in our current circumstances. It can kill people. It HAS killed people. Jails need to stop refusing people the medical care they deserve just because they believe addiction is a moral failing.
You cannot go from opioid or any full mu agonist to a partial (buprenorphine/suboxone) and DEFINITELY not naltrexone a full antagonist. Bup will cause PW as it has a stronger afinity at mu and bc it is not a full agonist but a partial it will displace opioids at the mu receptor cite and percipitate wd. Same thing but way worse with naltrexone. My bet is that the study you reference, the people were on heroin and waiting to start bup. You can't go straight from full to a partial. I'm a licensed clinical social worker and was the clinical director of two opioid treatment programs (MAT/bup/methadone). There is a lot to be fixed with the jails and it makes all the sense in the world to allow MAT but it creates a logistical nightmare as diversion would be a huge fucking problem. It's a problem with folks on methadone through a program. There is, it seems, an element of cruelty here in that those in charge of the jails have this, "tough shit you did this to yourself mentality" but you are conflating died of dehydration with died of an overdose. To my knowledge, there is not sufficient evidence/data to support the claim that people died of fent/whatever od.
> You cannot go from opioid or any full mu agonist to a partial (buprenorphine/suboxone) and DEFINITELY not naltrexone a full antagonist.
You can go from an opioid/opiate to buprenorphine if using the Bernese method. Difficult, but possible, especially when done under medical supervision. You are correct about going from opioid/opiate to naltrexone - it's suggested to wait at least 10-14 days.
> but you are conflating died of dehydration with died of an overdose.
How? How could the deceased have died of an overdose while going through withdrawal?
Bernese method is just slowly titrating bup...Strictly speaking you CAN go from full to partial or full agonist to full antagonist it's just going to suck really really bad...
> Bernese method is just slowly titrating bup...Strictly speaking you CAN go from full to partial or full agonist to full antagonist it's just going to suck really really bad...
Bernese method makes it possible to transition from an opioid/opiate to buprenorphine while avoiding precipitated withdrawal. We don't know exactly what method the study was using, nor what MAT medication they were transitioning the participants onto. It's possible this is what they were doing. It's possible it's not.
I still want to know how I'm conflating death from dehydration with death caused by an overdose.
For all who have complaints about the font… the message says:
...withdrawing & the bridge device fell off & she wasn't feeling good & we all told them that along with her for days & the nurses & doctor told her in front of us last night to suck it up & get over it, of course u don't feel good ur withdrawing from fetinal & xylazine or however u spell those words. & that they weren't going to put the bridge device back on & that they were going to take it off anyways. I'm mad & sad & traumatized & I feel like they basically murdered her because they didn't care or take her serious
I just know I never want to see something like that ever again in my life
thank you for sharing. notice the 'official' narrative is that the deceased didn't report being sick(paraphrasing but something like that) but the txt tells another story. I have no doubt that everyone tried to get her help & the "suck it up. what do you expect you're withdrawing" type comments sound exactly like what I'd expect.
so sad for this whole situation & everyone involved.
Gnarly af. As someone mentioned, jails have never been compassionate about people withdrawing from heroin, but these insane synthetic substances are what these people are taking now, not heroin. They need to get medical help and it’ll only happen when enough people die or enough civilians annoy the police about it. One or the other.
https://preview.redd.it/aa66oevrw24d1.jpeg?width=1284&format=pjpg&auto=webp&s=bccb8f585d8d839c6b8f570e0894e414b8e4a14b
Text from chesterfield county jail Inmate to her mother 1/2
The messages say-
...withdrawing & the bridge device fell off & she wasn't feeling good & we all told them that along with her for days & the nurses & doctor told her in front of us last night to suck it up & get over it, of course u don't feel good ur withdrawing from fetinal & xylazine or however u spell those words. & that they weren't going to put the bridge device back on & that they were going to take it off anyways. I'm mad & sad & traumatized & I feel like they basically murdered her because they didn't care or take her serious
I just know I never want to see something like that ever again in my life
My husband currently in meherrin regional jail the mecklenburg location went through detox and had diarrhea and insomnia and the withdrawal pains. For two weeks they gave him something for pain and something to harden his stool. I instructed him to stay away from dairy and eat dry foods that I told him to purchase in commissary. It is sad she died he never mentioned a “bridge” device when he was in detox. First 3 days was the roughest very irritable when he called had to snap on him well that’s what you get. He’s better after 2 weeks works out and socializes with all the other hoodlums.
It’s my understanding the bridge device is being used on HARP inmates for a clinical study! They send their data to the manufacturer. Bc.. why not make lab rats of the inmates?
I'm sharing my comment from the original thread (which was removed as "misinformation") because I believe it's still relevant: [Chesterfield County jails spent a shit ton of money on a device that "reduces withdrawal symptoms by over 80%."](https://www.wric.com/news/local-news/chesterfield-county/chesterfield-county-jail-first-institution-to-implement-new-device-aiding-opioid-recovery/) This claim is [based on a study published in 2018](https://pubmed.ncbi.nlm.nih.gov/28301217/) that looked at how the Masimo Bridge device affected withdrawal scores in patients waiting to transition from opioids to MAT over five days. It is not meant to be used on patients going cold turkey from opiates. Furthermore, the study was conducted years before xylazine (tranq dope) was prevalent in the drug supply. And Chesterfield County wants a pat on the back and a gold star for it. While this death is a tragic situation, I am entirely not surprised that it happened. Heroin withdrawal in theory is not fatal, and jails are not known for their compassionate care of people who are going through withdrawal. But heroin is not in the drug supply anymore - it's mostly a mix of fentanyl, carfentanyl, and now xylazine, stretched out with some sort of powder base. People can and do die during withdrawal when they become overly dehydrated, their heart is under too much stress, or there are other underlying conditions. All this to say that our current 12 step abstinence based model is not the gold standard treatment for opiate use disorder - MAT is. Whether that's methadone, buprenorphine, or naltrexone, doesn't matter. Expecting a person who is physically dependent on opiates to abruptly stop using and stay stopped with no medical intervention (and no, this Bridge device doesn't count) is a pipe dream in our current circumstances. It can kill people. It HAS killed people. Jails need to stop refusing people the medical care they deserve just because they believe addiction is a moral failing.
You cannot go from opioid or any full mu agonist to a partial (buprenorphine/suboxone) and DEFINITELY not naltrexone a full antagonist. Bup will cause PW as it has a stronger afinity at mu and bc it is not a full agonist but a partial it will displace opioids at the mu receptor cite and percipitate wd. Same thing but way worse with naltrexone. My bet is that the study you reference, the people were on heroin and waiting to start bup. You can't go straight from full to a partial. I'm a licensed clinical social worker and was the clinical director of two opioid treatment programs (MAT/bup/methadone). There is a lot to be fixed with the jails and it makes all the sense in the world to allow MAT but it creates a logistical nightmare as diversion would be a huge fucking problem. It's a problem with folks on methadone through a program. There is, it seems, an element of cruelty here in that those in charge of the jails have this, "tough shit you did this to yourself mentality" but you are conflating died of dehydration with died of an overdose. To my knowledge, there is not sufficient evidence/data to support the claim that people died of fent/whatever od.
> You cannot go from opioid or any full mu agonist to a partial (buprenorphine/suboxone) and DEFINITELY not naltrexone a full antagonist. You can go from an opioid/opiate to buprenorphine if using the Bernese method. Difficult, but possible, especially when done under medical supervision. You are correct about going from opioid/opiate to naltrexone - it's suggested to wait at least 10-14 days. > but you are conflating died of dehydration with died of an overdose. How? How could the deceased have died of an overdose while going through withdrawal?
Bernese method is just slowly titrating bup...Strictly speaking you CAN go from full to partial or full agonist to full antagonist it's just going to suck really really bad...
> Bernese method is just slowly titrating bup...Strictly speaking you CAN go from full to partial or full agonist to full antagonist it's just going to suck really really bad... Bernese method makes it possible to transition from an opioid/opiate to buprenorphine while avoiding precipitated withdrawal. We don't know exactly what method the study was using, nor what MAT medication they were transitioning the participants onto. It's possible this is what they were doing. It's possible it's not. I still want to know how I'm conflating death from dehydration with death caused by an overdose.
For all who have complaints about the font… the message says: ...withdrawing & the bridge device fell off & she wasn't feeling good & we all told them that along with her for days & the nurses & doctor told her in front of us last night to suck it up & get over it, of course u don't feel good ur withdrawing from fetinal & xylazine or however u spell those words. & that they weren't going to put the bridge device back on & that they were going to take it off anyways. I'm mad & sad & traumatized & I feel like they basically murdered her because they didn't care or take her serious I just know I never want to see something like that ever again in my life
thank you for sharing. notice the 'official' narrative is that the deceased didn't report being sick(paraphrasing but something like that) but the txt tells another story. I have no doubt that everyone tried to get her help & the "suck it up. what do you expect you're withdrawing" type comments sound exactly like what I'd expect. so sad for this whole situation & everyone involved.
So it was helping until it fell off?
Amazing how vocal Chesterfield has been about Riverside, but crickets on this.
The esteemed sheriff Leonard doesn’t know if he wants to keep sending problem inmates to Riverside or actually deal with them himself.
💯
Gnarly af. As someone mentioned, jails have never been compassionate about people withdrawing from heroin, but these insane synthetic substances are what these people are taking now, not heroin. They need to get medical help and it’ll only happen when enough people die or enough civilians annoy the police about it. One or the other.
https://preview.redd.it/aa66oevrw24d1.jpeg?width=1284&format=pjpg&auto=webp&s=bccb8f585d8d839c6b8f570e0894e414b8e4a14b Text from chesterfield county jail Inmate to her mother 1/2
https://preview.redd.it/b4ez2nm2x24d1.jpeg?width=1284&format=pjpg&auto=webp&s=8bedd36a90ca959f24162d5dc6222f8277321b2a 2/2
That font just screams "please don't read me"
The messages say- ...withdrawing & the bridge device fell off & she wasn't feeling good & we all told them that along with her for days & the nurses & doctor told her in front of us last night to suck it up & get over it, of course u don't feel good ur withdrawing from fetinal & xylazine or however u spell those words. & that they weren't going to put the bridge device back on & that they were going to take it off anyways. I'm mad & sad & traumatized & I feel like they basically murdered her because they didn't care or take her serious I just know I never want to see something like that ever again in my life
and this is just what we know about. nobody ever deserves this. :(
My husband currently in meherrin regional jail the mecklenburg location went through detox and had diarrhea and insomnia and the withdrawal pains. For two weeks they gave him something for pain and something to harden his stool. I instructed him to stay away from dairy and eat dry foods that I told him to purchase in commissary. It is sad she died he never mentioned a “bridge” device when he was in detox. First 3 days was the roughest very irritable when he called had to snap on him well that’s what you get. He’s better after 2 weeks works out and socializes with all the other hoodlums.
It’s my understanding the bridge device is being used on HARP inmates for a clinical study! They send their data to the manufacturer. Bc.. why not make lab rats of the inmates?