Narcan use is on the rise to reverse ODs in LA County jails. Officials quiet on source of illegal drugs

Los Angeles County has been administering naloxone, the opioid overdose reversal drug, to people held in county jail much more often — a hundred or more times each year — since at least 2020, according to county data.

In an interview this week with LAist, authorities within the Sheriff’s Department, officials acknowledged that overdoses are a serious issue, but stopped short of detailing how the drugs are getting into the facilities. The department runs county jail system, the largest in the nation.

“We know we have a problem, [and] we are looking. And we are trying to solve that problem,” Paula Tokar, acting assistant sheriff of Custody Operations, said in an interview with LAist.

No tracking of incidents

Because the department does not currently track how many overdose incidents occur in the jails each year, it’s difficult to get an accurate picture of how big the problem is. Citing federal privacy law related to medical information, the Sheriff’s Department said in an email to LAist that it cannot track total overdose incidents in its facilities.

The department does release information about deaths in county custody, including those linked to drug overdose.

For now, the use of naloxone in the jails provides a window into how widespread drug use may be. Department data show naloxone, known by the brand name Narcan, has been administered increasingly over the last four years. It was given to people in county jail more than 230 times in 2022.

Michelle Parris, program director with the Vera Institute of Justice — a group that wants to end mass incarceration — told LAist earlier this month it was difficult to contextualize recent overdoses because there just isn’t much information made available.

“We still have a long way to go to understand what’s actually happening in the jails around drug use, overdoses, reversal of overdoses and deaths,” Parris said. “The Sheriff’s Department has an approximately $4 billion budget, which includes a mandate to keep people safe and alive in their custody. And so it’s incredibly important that people not die in the jails."

Narcan by the numbers

According to the L.A. County Sheriff’s Department, jail staff administered Narcan about two-and-a-half times more this year so far than they did in 2020. According to the department, some records before 2022 may not be complete because the information was collected in paper logs instead of in the newer, electronic reporting system.

The most recent data show:

• In 2020, 54 people in the jails received doses of Narcan to reverse a potential overdose.
• In 2021, 202 people in the jails received doses.
• In 2022, 236 people received doses, the highest number over the past four years
• In 2023, 189 people in jail received doses.

So far this year, 140 people were administered Narcan, a number that is likely to rise.

Drug overdose deaths have been rising exponentially

Tokar stressed that the jails were not immune to the nationwide issue of overdoses resulting from the proliferation of fentanyl.

“The same way the community is seeing this — the overdoses and the unfortunate deaths from fentanyl — we’re seeing the same thing in the jails,” Tokar said.

Over the past decade, drug overdose deaths — specifically related to opioids, like heroin, fentanyl and many prescription painkillers — have risen exponentially in L.A. County and around the country. This week, the L.A. County Department of Public Health noted that the number of opioid deaths had "plateaued," meaning there was only a small change — a 4% drop — when comparing 2023 to 2022.

A local public health official suggested that a strategy known as harm reduction, which includes making Narcan more widely available, helped make a difference.

According to a report released in May by the L.A. County Office of Inspector General, 12 of the 45 people who died at county jails last year had overdosed on drugs.

Tokar said the department's propensity to follow a "when in doubt, give that Narcan" philosophy is a big factor in the increased instances of using the medication inside the jails. Jail staffers, she explained, are urged to use it whenever they see signs of overdose.

Once Narcan is administered — either by jail staff or other incarcerated people — Tokar said there is no follow up reporting back to the Sheriff’s Department on whether a person had indeed overdosed.

Tokar said the department has increased random searches of employees coming through the jails and jail staff are required to have clear bags. She said the department was also regularly scanning mail, using body scanners, and has increased its use of drug detecting dogs.

Authorities quiet on how drugs get into jails

The Sheriff’s Department would not say how often illicit drugs get into the jail system. And the department did not point to any reports showing how often drugs were smuggled in by incarcerated people or jail staff.

“We know that there is a problem — a large problem — where we have illegal narcotics coming in, but as compared to last year, I can’t say there’s any difference,” Tokar said.

Most law enforcement experts acknowledge that illicit drugs have been smuggled into jails — in a variety of jurisdictions — by visitors and staffers who carry them in. Drugs can also get into the facilities through mail.

The L.A. Times reported in May that a deputy had been arrested for allegedly smuggling drugs into an L.A. County jail. Last year, a deputy working at a jail in Riverside County was arrested for allegedly having more than 100 pounds of fentanyl.

LAist reported earlier this month that there were seven non-fatal overdoses at the women’s jail in Lynwood between May and June of this year.

Tokar confirmed that six of those overdoses occurred on the same date, which she said was uncommon. That incident is still under investigation, but Tokar said that they believe that the individual who found the narcotics was on a cleaning crew for one of the reception centers.