More and more instances are being reported in the news of people dying from benzodiazepine withdrawal while incarcerated for relatively minor offenses.

Jesse Jacobs

Take Jesse Jacobs, 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 withdraw symptoms, and it can de deadly. We are not talking about people on heroin; everyone knows that can be deadly to withdraw from.”

Another deceased inmate in Michigan, serving time for a traffic ticket, is another gruesome story.  David Stojcevski, 32, who was on xanax, and several other medications, 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.  This also has resulted in a 30 million dollar lawsuit.

These are just  two recent examples of many inmate deaths from benzodiazepine withdrawal. It is impossible to predict which inmates will die and which will not from an abrupt withdrawal from a benzodiazepine.  Because death is a risk, a slow taper is the only way to prevent these deaths.

This has prompted some jurisdictions, such as Cuyahoga County passing Sean’s Law, named after Sean Levert, who died in jail from benzodiazepine withdrawal, with a policy to protect those on benzodiazepines, other counties have no policy, or unfavorable policies regarding the potential danger.  Variations in policy from jurisdiction to jurisdiction make it an unpredictable risk for prescribers and patients.  Because of this, informed consent is essential at the beginning of treatment, so the patient can access their risks and decide for themselves if it is a risk they want to take.

Clearly, the first step is to never become dependent on benzodiazepines to begin with.  Prevention of dependency on benzodiazepines starts with adhering to prescribing guidelines, which would require doctors to only prescribe benzodiazepines for 2 to 4 weeks.  These guidelines are largely ignored.  To date, we cannot know which patients can abruptly stop a benzodiazepine without risk of death, or injury, and which will be injured or die.  We cannot foresee the future or what circumstances patients may face.  We cannot predict when or where these patients may find themselves in a situation where they cannot access their prescribed benzodiazepine.

What we do know is both Jesse and David, and many others, would most likely be living today had they not been dependent on a benzodiazepine in the first place, or detoxed abruptly from a jail.  We also know how to prevent it.  But we have to stop ignoring the problem, and take action.

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