Narcan used for inmate overdoses every 12 days on average inside Nashville jails

A medical incident earlier in November prompted some questions about how frequently overdoses are happening in Nashville’s jails. So far in 2018, medical staff have responded to, and used Narcan in, a total of 29 cases within Davidson County Jails – once every 12 days, on average.

On what was an otherwise normal Friday morning at 7 A.M. in the D1 housing unit inside a Nashville jail, which houses 61 inmates in an open barracks style unit, there was a sudden medical emergency with an inmate. 32-year-old James Livingston, who has been in custody since October for felony gun & drug charges, had collapsed in an apparent overdose, and a ‘CODE GREEN’ was called.

As Nurse Karla Ayala arrived to the scene, she had to cut off the inmate’s shirt to complete a medical assessment. As she removed the shirt, she placed it on the top empty bunk above her new patient, and Officer Ansotegui removed two bags from the shirt, one of a white powdery substance, the other a pink powdery substance. An officer and a CCS medical nurse suspected the pink substance was ‘pink elephant heroin’ per a DCSO incident report obtained by Scoop: Nashville.

It was later determined that both baggies from inmate Livingston’s shirt contained heroin, and both internal and criminal charges were brought against him. Immediately after Livingston was treated, the unit was searched thoroughly by officers, and again during the night shift. Reports submitted that day show that marijuana wrapped in paper inside a sock, six $1 bills, and an altered inmate radio, were all recovered and considered contraband. DCSO does not have a report that tallies the total contraband recovered, or number of similar incidents, but does say in a statement:

“it is an everyday struggle in any correctional facility and our corrections staff work diligently every day to minimize the impact by doing searches and trying to eliminate it to the best of their ability”.

Similar incidents have played out in Nashville’s Jails 29 times so far in 2018, slightly up from the 28 times in 2017 – but those numbers were not easy to come by. The Davidson County Sheriff’s office did not have a tally of the number of overdose or Narcan treated incidents when a formal request was submitted. Instead, they referred us to the Health Department, who manages inmate healthcare for inmates in Nashville. The health department also did not have any information available about the number of overdose or Narcan incidents, but was able to get the information from Correct Care Solutions (CSS), who contracts with the city to provide the actual services for inmates.

According to CCS, in 2017 they responded to 28 suspected overdose cases of inmates within Nashville’s jail system, all of which were treated with Narcan. 22 of those patients had prior substance diagnoses. 4 of the overdoses required hospital admissions, for a total of 6 inpatient hospital days.

So far in 2018, CCS has responded to, and treated with Narcan, a total of 29 cases – once every 12 days, on average. 21 of those patients had prior substance abuse diagnoses in their records, and 4 required hospital admissions, for a total of 5 inpatient hospital days.

We were also able to obtain the cost of the Narcan used inside secure Davidson County jails for the same period. Including the amount currently on-hand, $10,239.75 has been spent on Narcan for Nashville inmates since 2017.

DCSO reports that 8 inmates have died in custody since 2017, 4 each year. It was not immediately known how many, if any, were related to drug use or overdose inside a facility.