Large facility benefits from model drug-testing program.
Like most major metropolitan areas across the country, Kansas City has experienced a dramatic increase in violent, drug related crimes among youths. Detained youths have become increasingly aggressive in recent years, which presents complex management issues. The juveniles entering detention facilities today are more sophisticated and are usually repeat offenders.
The Jackson County Juvenile Detention Center, a secure 68-bed detention facility in Kansas City, Mo., had been considering implementing a drug-testing program for some time before participating in the ACA/IBH training program. Staff at the facility, which is primarily used for pre-adjudication detention with an average length of stay of 13 days, recognized the importance of having a system to identify juveniles entering the facility under the influence of drugs.
Many of our juveniles have entered the facility experiencing the effects of or withdrawal from a variety of street substances, especially PCP and cocaine. Unfortunately, we had no method of objectively verifying their level of intoxication. We were forced to rely upon our own observations and the word of the detainees as to what drugs they were on and how much they had ingested. Such subjective evidence obviously is not sufficient in rendering care, custody and control. Also, many detainees would vehemently deny drug use despite obvious signs to the contrary.
Being selected by ACA as the large juvenile detention facility for this year-long pilot program opened the door for the development of a facility-wide drug-testing program. Prior to attending the drug-testing training sponsored by ACA/IBH in February 1993, a committee had been meeting weekly to develop a training curriculum and to explore the details of implementing a drag-testing program in the facility, such as locating and contracting with a local laboratory certified by the National Institute on Drug Abuse (NIDA).
The ACA/IBH training provided us with a wealth of useful information relevant to all institutional personnel; administration, medical personnel and line staff alike gleaned information that was applicable to their jobs. Another benefit of the training was the opportunity to meet and interact with other professionals facing similar challenges in the field of juvenile justice.
The Jackson County Detention Center outlined specifically what we expected of the drug-testing program. We wanted the program to: 1) allow for the timely detection of drug use to insure the safety and health of the juveniles entering the facility; 2) examine the correlation between drug use and delinquent behavior; 3) provide appropriate intervention, education and treatment to assist rehabilitative efforts; 4) assist in the classification and daily management of juveniles during their detention; and 5) provide a data base to determine trends in drug use and needs for related services.
Because of the large size of our facility and the volume of admissions, we chose to contract with a large NIDA certified laboratory. The lab provided all forms and collection kits, as well as a courier service. The lab also was able to provide test results within four hours via fax. We chose to test routinely for four substances: marijuana, amphetamines, PCP and cocaine. We also had the option of testing for other drugs, such as benzodiazepines, LSD or opiates.
Since implementing the program in April 1993, we have experienced occasional difficulties with juveniles refusing to submit to testing, attempts to dilute samples and other attempts at tampering. Initially, staff had some trouble incorporating the new procedures into their already heavy work-load. Staff were intensively trained on proper methods of sample collection, with particular emphasis on issues pertaining to chain-of-custody and adherence to universal precautions.
Within two weeks of the inception of this program, a newly admitted detainee arrived at our facility exhibiting strange behavior. Per written policy, he was placed into isolation to allow for closer observation. Staff documented his behavior and actions, noting that he began screaming and banging his head and appeared to be hallucinating. The urinalysis results showed that he was under the influence of PCP, cocaine and marijuana. All levels recorded were substantially above the cutoff levels for intoxication. Based on this information, the detainee was taken by ambulance to a local hospital, where he was provided medically managed detoxification. This was followed by 14 days of inpatient treatment tailored to his needs. He was then returned to our facility.
During the last year, similar situations involving detainees under the influence have arisen. As in the above situation, timely knowledge of a detainee's type and level of intoxication has proved to be invaluable in deciding on a course of immediate and long-term treatment. The value of drug-testing in a detention facility cannot be overstated.
Follow-up drug education and counseling sessions are available to all juveniles in the detention center. They are optional unless a detainee has positive urinalysis results. Drug education sessions and Alcoholics Anonymous and Narcotics Anonymous support meetings are offered at least once a week. The drag counselor also notifies parents and guardians by mail whenever their child tests positive for drugs on arrival. Additionally, information concerning educational and treatment options is provided to the client, parents and guardians.
Overall, parents have been very receptive to the drug testing program. We have had no incidents of a parent or youth challenging the results of a drag test. In fact, we have had parents comment that it was easier to confront their child about suspected drug use knowing that the child had tested positive in a urinalysis.
Year-end statistics have shown that 32 percent of all residents tested showed positive results for one or more substances. The most common drugs these residents tested positive for was marijuana, followed by PCP and cocaine. These findings are in keeping with results reported by the facilities in the metro area, although our PCP percentage appears to be higher.
When representatives from our agency left Kansas City for the drug-testing training in Baltimore, I was excited about acquiring new knowledge, but skeptical as to how the program could positively affect our facility.
Now, one year later, I would fight to keep this program funded and viable. I also would encourage other facilities, large or small, urban or rural, to explore their options in implementing a drug-testing program. As professionals, we owe it to ourselves and our clients to have as much information available to us as possible. Breaking down the walls of denial by being armed with timely, accurate facts is the place to begin.
Lisa Bara is a detention nurse at the Jackson County Juvenile Detention Center.
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|Title Annotation:||Jackson County Juvenile Detention Center in Kansas City, MO; American Correctional Assn.'s urine drug-testing program|
|Date:||Aug 1, 1994|
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