Jail staff sees aftermath of drug addiction daily

Telsa Feltner, a training officer at the Rappahannock-Shenandoah-Warren Regional Jail in Warren County, looks at her computer screen inside the jail's intake area. Rich Cooley/Daily

FRONT ROYAL – Staff at the Rappahannock-Shenandoah-Warren Regional Jail see the aftermath of the drug epidemic every day.

Most inmates at the jail are there on low level offenses, mostly related to addiction.

The No. 1 charge of inmates at the jail on an average day is parole violation.

“I would say at least 98 percent of those who violate their probation is because of narcotics use,” said Superintendent Russ Gilkison.

The second most common charge is possession of a schedule 1 or 2 narcotic.

Rachel Lamb, a medical tech at the jail, pulls medications for inmates. Rich Cooley/Daily

The fight to reclaim a life from the downward spiral of drugs begins at intake.

Arresting officers are to have already patted down people they have arrested to find any drugs on them. Inmates brought into the jail go through a secondary search in case they still have  something on them. The inmates are strip-searched when changing into a jail uniform.

“I am looking for any type contraband, and I am looking to see what their mental state is… are they drunk, are they going through withdrawal,” said Capt. Joshua Jacobson.

Staff sees the relaxed personality that comes with marijuana use, the incoherent babbling that belies heroin use, the paranoid agitated nature of meth and even PCP, jail staff said.

Inmates are kept in a preliminary intake cell for the first 24 to 48 hours. That allows new inmates to remain separated from the general jail inmate population while corrections officers monitor them for signs of possession of drugs, drug use, withdrawals, and violent or dangerous behavior. They try to catch any problems and keep it out of the main part of the jail.

Lindsey Hedrick, left, a licensed practical nurse, and Lori Smith, right, nursing director at Rappahannock-Shenandoah-Warren Regional Jail, work inside the nurse's station at the jail. Rich Cooley/Daily

There are 24 holding cells in intake that corrections officers monitor.

Several inmates on a recent visit lie on a mat on the floor of their holding cell trying to sleep.

A male inmate is on suicide watch, and corrections officers have to check on him every 15 minutes.

One of the corrections officers watching inmates in person and by camera on a collection of small screens is Telsa Feltner.

“Everyday is different. We have to be observant,” Feltner said.

Capt. Joshua Jacobson is shown at work in the jail's processing area. Rich Cooley/Daily

Inmates are medically screened on arrival.

Physicians assistant Peter Ober sees inmates who are very ill, including those with infections  like hepatitis.

“They do not seek out treatment outside of jail because of socio-economic conditions,” Ober said.

He estimates that 18 percent of the men and 30 percent of the women he sees in all of the jails he serves have a serious mental illness, such as schizophrenia.

“Many do self-medicate (with narcotics),” Ober said.

Peter Ober, a physicians assistant at the jail, sees many inmates with opiate withdrawal symptoms. Rich Cooley/Daily

Working in conjunction with him is nurse director Lori Smith and the staff of nurses she oversees.

“It’s very busy,” Smith said.

Part of the medical assessment they do is an opiate withdrawal protocol, and they detail inmates’ substance abuse histories. Once that is obtained, the staff works with the on-call medical provider to determine orders and medication.

Ober said an addict going through withdrawal feels 10 times more sick than someone with the worst flu anyone can imagine.  To go through that while being in jail is miserable, he said.

He added that patients could receive anti-nausea medication to stop vomiting and medication to stop “the shakes” often associated with withdrawal. They may  also be given fluids to hydrate as well as vitamins.

While in the jail, inmates have access to a mental health professional.

Elisabeth Gochenour, a mental health professional who works for Northwest Community Services, sees about nine inmates each day. Substance abuse, she said, starts early.  She has talked to people who started using alcohol or even drugs at the age of 6, 7 or 8 years old.

“I have seen parents give a can of beer to a kid at 3 years old and take a picture,” she said.

One of her responsibilities is to evaluate whether an addict at the jail is ready and wants to be helped. If so, a person can begin substance abuse classes.

Gochenour starts sessions for those who are ready in an attempt to get to the root of their addiction. She will begin working with an inmate on developing coping skills, including a group coping skills class, as well as grief classes and trauma classes.

Northwest uses outpatient treatment such as:

  • 24-hour emergency/crisis intervention and hospital pre-screening.
  • Substance abuse services.
  • Screening for and referrals to detoxification, residential treatment, and halfway house/sober housing services within the region and, when necessary, in other areas of the state. Examples of these services include: Boxwood Detoxification and Residential Treatment.
  • Services for women using substances include group counseling, case management, and screening and referral for detoxification, residential treatment, and halfway house/sober housing services.

Northwest uses medication-assisted treatment for drug addiction, such as Suboxone or methodone, which is done at facilities or hospitals outside of the jail.

Staff sets inmates up with programs to continue support after they leave the jail, a time when inmates are more at risk of relapse and overdose.