Go to jail. Die from a benzodiazepine prescription.
There is an alarming trend happening in correctional institutions. Prescribed benzodiazepine-dependent patients, often incarcerated for minor infractions, are dying. After being denied their prescription and medical care, they are forced into abrupt benzo withdrawals. This is resulting in harm, suicide and death. Lawsuits are filed (and usually won), but it’s too late. This inhumane treatment of the incarcerated needs to be urgently addressed.
Jesse Jacobs was a 32 year old Texas man prescribed Xanax for an anxiety disorder. He was sent to jail for 30 days for a driving while intoxicated conviction. While in jail, Jacobs died from Xanax withdrawal. His death has resulted in a hefty lawsuit, and has enraged the ACLU, stating that “A part of this is familiar to us is jails often fail to identify with withdrawal symptoms, and it can be deadly.”
David Stojcevski, who was 32 at the time of his death, is another now-deceased inmate in Michigan who was serving time for a $772 unpaid traffic fine. Stojcevski was on prescribed Xanax, and several other medications. He died 16 days into his 32-day sentence. His death and the preceding events were caught on video, which illustrates the excruciating, deadly process that benzodiazepine withdrawal can be. While federal prosecutors declined to press charges against the facility, a 30 million dollar lawsuit was filed.
Cuyahoga County in Ohio passed Sean’s Law, named after singer Sean Levert, who died in jail from benzodiazepine cessation, which is a policy to protect those on benzodiazepines. Levert, 39, was jailed on March 24, 2008 for owing nearly $90,000 in child support to three children from previous relationships. He died after being denied his prescribed anti-anxiety medication, Xanax, the entire time he was in jail. A coroner’s report said Xanax withdrawal contributed to Levert’s death. The widow of Sean settled her lawsuit against the county and the company that oversees medical care in the jail for $4 million. Other counties have no policy or unfavorable policies, regarding the potential danger of abrupt benzodiazepine cessation by way of denying inmates their medications of which they are dependent. These variations in policy from one jurisdiction to another make the jailing of iatrogenically dependent benzodiazepine patients an unpredictable risk for both prescribers and patients. For this reason (and many others), informed consent is essential at the time of initiation of benzodiazepine treatment so that the patient can fully access their risks.
A Plain Dealer review showed the Cuyahoga County Jail did not have a formal policy for deciding if inmates should get their prescription medications shortly after arrival. Decisions were made on a case-by-case basis, with many prisoners having to wait up to three days before being evaluated. Some inmates had to wait up to two weeks before seeing a doctor who would decide if they should be given medicine they had been prescribed. Benzodiazepine damage can occur within hours or days.
As a result, the jail adopted a policy in 2010, exactly one year after Levert’s death, saying that inmates taking anti-anxiety drugs should be given those drugs once their prescriptions are verified. If the prescription can’t be verified, the inmate should be scheduled to see a psychiatrist that day or the next.
“Sean’s Law,” named for the singer and sponsored in the Ohio General Assembly by State Rep. Barbara Boyd, D-Cleveland Heights, would require every county jail to give each inmate a medical, dental and mental health screening on arrival.
It seems the law was ignored. Joseph Arquillo, 47, an inmate in the same facility as Sean Levert, died in 2019 under the very same circumstances. Another inmate, Richard T. Andrews, was paid $300,000 in 2017 for suffering Xanax withdrawal symptoms and seizures, resulting in several surgeries after sustaining bilateral shoulder fractures and dislocation.
In 2020, new legislation was announced by Ohio State Senator Nickie J. Antonio, requiring Ohio’s jail system to have protocols in place when admitting inmates who are at risk of withdrawal from drugs, alcohol, and/or other prescription benzodiazepines, such as Xanax, Ativan and Valium.
John Patrick Walter
John Patrick Walter was allowed to slowly and painfully expire from a benzodiazepine cold-turkey withdrawal in Fremont County jail. He had not been formally charged with a crime but was taken into custody after an altercation with an acquaintance. He could not afford to pay his bond and died in jail on April 20, 2014. His family filed a lawsuit which contends that he died of withdrawal from Klonopin after 18 days of suffering. On multiple occasions, Walter was strapped into a restraint chair, where he was tased and pepper-sprayed over his histrionics. But he did even greater damage to himself, kicking and hurling himself against walls with such force that it is believed he broke several bones. Walter weighed 200 pounds at the time of his incarceration and, due to the withdrawal he endured, had lost between 30 and 50 pounds during his 18-day stay in Fremont County jail.
Richard White, fortunately, did not die from his jail-initiated benzodiazepine cessation.Maimed by the jail’s policies, he sued five southeastern Ohio counties for denying him medication and care while withdrawing from an anti-anxiety drug. This denial resulted in White jumping from a second-floor jail ledge onto a concrete floor, breaking both of his legs and ankles. The Zanesville Times-Recorder reports Richard White’s federal lawsuit says White’s doctor had been tapering him off benzodiazepines before his February 2016 arrest for a parole violation.
Dylan Harrison Straton
Dylan Harrison Straton, 21, died while in custody at Kentucky’s Franklin County Regional Jail for after being arrested for drug and wanton endangerment charges. His mother, Leslie Glass, said he had been struggling with the death of his step-father. He was found dead in his cell after days of lack of treatment and suffering from benzodiazepine withdrawal symptoms.
A lawsuit was filed, stating:
Dylan would not have died but for Defendants’ gross, unconscionable and deliberate indifference to the tortures of his untreated benzodiazepine withdrawal.
Darius Robinson, 41, was jailed for not paying child support. He was denied Xanax and started to experience withdrawal symptoms. He then became agitated. He was restrained in a neck hold by officers in his jail cell. No charges for his death were filed.
Other Notable Inmate Cases
Brianna Beland, 31, Dino Vann Nixon, 55, Gregory Lee Hill, 26, John Wayne Siple, 44, Tyler Taber, 25, Jen McCormack, Paul Bulthouse, 39, and Nancy Bourgeois, 41, were incarcerated and died from abrupt benzodiazepine cessation. All resulting in lawsuits. Vincent Dwayne Young, 32, and Leo Marino, 41, ended their own lives after being denied access to their medication (Xanax and Klonopin, respectively), suffering abrupt benzodiazepine cessation. Both deaths resulted in lawsuits. Jessica D. Huber hospitalized after nearly dying from her forced benzodiazepine cessation.
What Needs to Change?
The first step to prevent death from benzodiazepines withdrawal is to never become physically dependent on benzodiazepines to begin with. Prevention starts with adhering to prescribing guidelines, which would require doctors to only prescribe benzodiazepines for 2 to 4 weeks or less. These guidelines are largely ignored in medicine today. Prescribers cannot foresee the future and predict future incarceration in their patients as many of the incarcerated benzodiazepine deaths were for relatively minor infractions.
It is important to note that anyone who is subjected to rapid cessation after regular prescription of benzodiazepines is at risk for death and/or severe benzodiazepine injury and withdrawal. This is not just a problem in the jail, but is probably seen more readily there, as inmates can’t go to the emergency room and have little to no agency about their health while incarcerated.
Currently, It is up to the state, county or individual prison or jails on how they will handle benzodiazepine-dependent inmates. Federal Bureau of Prisons has established a policy for the detoxification of chemically dependent patients. It is important to note that this protocol is rapid cessation, which is too fast to be considered humane. These over-rapid cessations can leave the inmate vulnerable to benzodiazepine withdrawal syndrome and protected withdrawal syndrome. These syndromes are torture. Slow tapering, or leaving the patient on the medication, are the only safe, humane ways to prevent further deaths. Many prisons and jails have no benzodiazepine cessation policy at all. Safe benzodiazepine policies need to be implemented immediately.