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Policy 716Santa Ana Police Department Custody Manual Copyright Lexipol, LLC 2024/02/21, All Rights Reserved. Published with permission by Santa Ana Police Department***DRAFT*** Detoxification and Withdrawal - 1Detoxification and Withdrawal 716.1 PURPOSE AND SCOPE Significant percentages of incarcerated persons have a history of alcohol and/or drug abuse. Newly incarcerated individuals may enter the facility while under the influence of a substance or they may develop symptoms of alcohol or drug withdrawal. This policy is intended to ensure that the staff is able to recognize the symptoms of intoxication and withdrawal from alcohol or drugs, and that those persons who are intoxicated or experiencing withdrawal are provided appropriate medical treatment. This policy also identifies protocols to be used by qualified health care professionals. These protocols are appropriate for incarcerated persons who are under the influence of alcohol or drugs or who are experiencing withdrawal from any type of substance abuse. 716.1.1 DEFINITIONS Definitions related to this policy include: Alcohol withdrawal - A medical condition characterized by physiological changes that occur when alcohol intake is discontinued in an individual who is addicted to alcohol. Detoxification - The process by which an individual is gradually withdrawn from drugs by the administration of decreasing doses of the drug on which the person is physiologically dependent, or a drug that is cross-tolerant to the dependent drug, or a drug that medical research has demonstrated to be effective in detoxifying the individual from the dependent drug. 716.2 POLICY Withdrawal from alcohol or drugs can be a life-threatening medical condition requiring professional medical intervention. It is the policy of this department to provide proper medical care to incarcerated persons who suffer from drug or alcohol overdose or withdrawal. To lessen the risk of a life-threatening medical emergency and to promote the safety and security of all persons in the facility, staff shall respond promptly to medical symptoms presented by incarcerated persons. The Responsible Physician shall develop written medical protocols on detoxification symptoms necessitating immediate transfer of the incarcerated persons to a hospital or other medical facility, and procedures to follow if care within the facility should be undertaken (15 CCR 1213). Incarcerated persons who are booked into the facility who are participating in a narcotic treatment program shall, with the approval of the director of the program, be entitled to continue in the program until conviction (Health and Safety Code § 11222). 716.3 STAFF RESPONSIBILITY Staff should remain alert to signs of drug and alcohol overdose and withdrawal. These symptoms include but are not limited to sweating, nausea, abdominal cramps, anxiety, agitation, tremors, Santa Ana Police Department Custody Manual Detoxification and Withdrawal Copyright Lexipol, LLC 2024/02/21, All Rights Reserved. Published with permission by Santa Ana Police Department***DRAFT*** Detoxification and Withdrawal - 2hallucinations, rapid breathing, and generalized aches and pains. Any staff member who suspects that an incarcerated person may be suffering from overdose or experiencing withdrawal symptoms shall promptly notify the Shift Supervisor, who shall ensure that a qualified health care professional is promptly notified. 716.4 MEDICAL STAFF RESPONSIBILITY The qualified health care professional will evaluate the incarcerated person using approved protocols in order to determine the most appropriate care plan, which will be based on the patient's history, current physical status, and treatment needs. Any patient who cannot be safely treated in the facility will be referred to an appropriate treatment facility off-site. 716.5 PROCEDURE Incarcerated persons who are observed experiencing severe, life-threatening intoxication (overdose) or withdrawal symptoms will be promptly seen by a physician or referred to an off-site emergency facility for treatment. Detoxification shall be conducted under medical supervision at the facility or in a hospital or community detoxification center under appropriate security conditions. If the qualified health care professional determines that an incarcerated person is at risk for progression to a more severe level of withdrawal, the person will be appropriately housed in an area where they can be kept under constant observation by qualified health care professionals or trained correctional staff. 716.6 WITHDRAWAL AND DETOXIFICATION PROTOCOLS Protocols are available to the qualified health care professionals to guide the care and treatment of individuals who are intoxicated or experiencing drug and/or alcohol withdrawal. These protocols, which have been developed and approved by the Responsible Physician, fall within nationally accepted guidelines and are reviewed annually. When dealing with persons who are in a custody situation, qualified health care professionals shall utilize detoxification protocols in accordance with local, state, and federal laws. No direct supervision is required at the time of identifying and initiating care. Overall supervision is provided by the Responsible Physician. Qualified health care professionals shall evaluate and provide care to patients utilizing written procedures and/or physician orders. 716.7 ALCOHOL WITHDRAWAL SYMPTOMS CHART The following chart describes typical symptoms of mild, moderate, and severe withdrawal. It is to be used as a guide for determining when to refer incarcerated persons to a qualified health care professional. Not all symptoms are always present. MILD MODERATE SEVERE (Delirium Tremens) Santa Ana Police Department Custody Manual Detoxification and Withdrawal Copyright Lexipol, LLC 2024/02/21, All Rights Reserved. Published with permission by Santa Ana Police Department***DRAFT*** Detoxification and Withdrawal - 3ANXIETY Mild restlessness and anxietyObvious motor restlessnessExtreme restlessness and agitation with appearance of intense fear is common