Suicide Spotlights Quandary of Handling Junkies in Jail

It’s not an easy situation to evaluate: A junkie is arrested, tossed into jail and then begins complaining about the physical pain of heroin withdrawal. They can experience nausea, diarrhea, vomiting, even violent convulsions.

The nurse or doctor on duty must determine whether the prisoner should be given medical treatment, transferred to the medical ward or whether they can be left to endure their withdrawal in their cell. How medical professionals make that call is a mixture of observation and instinct, and the stakes, for the junkies and their jailers, are high. The pain of withdrawal, some addicts say, could drive someone to suicide.

“Sometimes you feel like banging your head on the bars,” said Michael Gonzalez, an admitted heroin user who has been addicted since age 15. “You don’t want to get high--you just want to feel normal.”

“It’s a burden to put on the system to deal with them,” said Dr. Duane Carmalt, who has helped more than 20,000 addicts through drug detoxification as medical director of the Tarzana Treatment Center. Some addicts genuinely need help, said Carmalt, but others might be trying to con their way out of a jail cell and into a medical ward. “These are some of the most manipulative people in the world.”

At least a few times a week, law enforcement officials throughout Southern California arrest heroin addicts and place them in cold, small cells far away from the ecstasy of their needles. Neither the Los Angeles Police Department nor the Los Angeles County Sheriff’s Department records the number of arrests for heroin use.

But records of drug arrests alone don’t adequately reflect the problem. Neither agency records how many times they will arrest someone for, say, burglary only to discover later that the arrest has forced a junkie to go cold turkey in jail.

Some statistics do provide a glimpse of their caseload. John Clark, chief of physicians for the Sheriff’s Department, said close to 70% of the 250,000 people booked through the department each year are processed on drug-related charges.

In Los Angeles in 1994, for example, of 65,178 people arrested on felony charges, 5,115 people were picked up for drug-related offenses, not including marijuana use.

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The challenges of handling drug addicts in jail became apparent with the recent death of Kathleen Barkley, a 35-year-old Valencia woman arrested on suspicion of prostitution. On June 25, Barkley killed herself inside a Van Nuys jail cell, wrapping a phone cord around her neck and dropping to her knees to choke herself to death.

Although Barkley’s family has hinted at possible foul play in her death, police said it appears unlikely that any of the other five other prisoners in cell was involved. “Look at the time of the morning when she died,” said Lt. Tony Alba, chief spokesman for the LAPD. “Everybody was sleeping. A cellmate woke to find her lying there.”

Barkley died during her third day in jail. A woman in a neighboring cell said Barkley had complained to officers for at least two days about experiencing heroin withdrawal. Barkley received some type of medical attention while in custody, but police have declined to specify what was done for her.

Barkley’s sister, Joyce Andrade, said Barkley called a roommate just after midnight a few hours before she was found dead at about 3 that morning. The roommate had talked Barkley through the first two days of her heroin withdrawal, which doctors agree is usually the most difficult period. Her sister apparently was feeling better, Andrade said, and supposedly looking forward to being arraigned, and possibly released, hours later.

Family members said Barkley went through similar heroin withdrawal before, most recently while visiting her mother in Big Bear last December. Even then, Andrade said her sister didn’t seem suicidal.

“She’s overdosed on the street and been harmed there,” Andrade said. “So I don’t think she was embarrassed or humiliated by being in jail, because she had been in there so many times. But I never thought she would get harmed in jail. If the pain got to the point where she wanted to commit suicide, then they should have done something about it.”

Barkley’s history of drug abuse went back many years, and another relative said she had been addicted to heroin for at least 15 years. She had been arrested several times before and lost custody of her three children to her ex-husband a few years ago.

Despite Barkley’s personal problems, her family remains mystified by her death. They also question how she could have killed herself by wrapping a 12-inch braided metal cord around her neck--and without anyone in the cell waking up. “I put something 12 inches around my neck and it barely fit,” Andrade said. “And my sister was a lot bigger than me.”

Alba said coroner’s officials had similar concerns and conducted their own experiment. “The coroner tried it out with the same size cord and it, indeed, it was effective,” Alba said. He also noted that LAPD had years ago shortened the telephone cords in hopes of preventing such suicides.

Although the pain of heroin withdrawal can be excruciating, medical experts said it is nearly impossible to die during withdrawal, although it can happen in extreme cases. For an addict to die in police custody is even rarer, police and drug counselors say. But it does happen.

In 1994, two men experiencing withdrawal symptoms died inside the Orange County Jail in the city of Orange.

Officials there said Leonard Romero, 52, was transferred to the medical jail ward during a bout with heroin withdrawal in December. Romero, being held on a petty theft charge, sat up in his hospital bed and then suddenly died.

One month earlier, 29-year-old David Madrigal had died in the same Orange County Jail facility. On Nov. 14, while on his way to the medical ward in a wheelchair, Madrigal slipped into unconsciousness and died.

These men received medical attention during withdrawal, even if the treatment was unsuccessful. But how do authorities assess an addict’s condition when they arrive at the jail?

Clark, of the Sheriff’s Department, said prisoners arriving at the eight sheriff’s facilities are evaluated by nurses. The nurses try to assess the severity of an addict’s habit and their potential for “placing themselves in life-threatening situations” by asking the inmate how much they spend on heroin each day and how long they have been addicted.

Carmalt, of the Tarzana Treatment Center, said a person spending from $300 to $500 a day on heroin generally has a moderate addiction. Junkies who spend at least $1,000 a day require substantial and immediate attention.

If a prisoner’s drug history is lengthy and their physical symptoms appear severe, they are given drugs like Thorazine or clonidine in the medical ward to ease the withdrawal. Clonidine lowers the blood pressure and calms the addict, while Thorazine is often used to relax hyperactive mental patients. In the past, some jail facilities administered methadone, a synthetic drug stand-in for heroin, but also a drug that can become addictive.

Alba said not every heroin addict who asks to be taken to the medical ward will be transferred. “Each case is different,” he said. “It’s up to the medical examiner to determine.”

Fernando Martinez, an admitted heroin addict from Van Nuys, said some addicts do exaggerate the severity of their withdrawal. But he also complained that police have little sympathy for addicts.

“They say it’s your fault you’re a junkie,” said Martinez, 34, who has been in and out of jail since becoming addicted at age 13. “Cops look down on junkies as it is. They like to see you curled up in the corner. Sometimes you can’t make it to the bathroom and you throw up there. That pisses off other prisoners and the police, because they don’t like the smell and don’t want to clean up after you. And a few times I got beat up by other inmates because I smelled up the place.”

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Whether dealing with longtime users like Martinez or someone trying to cut down on their habit--as Barkley’s relatives say she was--police are left with tough choices. In Barkley’s case, her family wants to know more about how those choices were made.

“We thought it was pretty strange when we heard how she died,” said a family member. “Kathleen’s not the type of person to commit suicide. She was too feisty and self-centered to do that. But stranger things have happened. When they are on the drug, people are so unpredictable.”