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Kevin Fiscella, MD, MPH, Naomi Pless, MD, Sean Meldrum, MS and Paul Fiscella, JD

Kevin Fiscella, Naomi Pless, and Sean Meldrum are with the Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY. Kevin Fiscella is also with the Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry. Paul Fiscella is in private law practice in Hampton, Va.

Correspondence: Requests for reprints should be sent to Kevin Fiscella, MD, MPH, Family Medicine Center, 885 South Ave, Rochester, NY 14620-2399 (e-mail: kevin_fiscella{at}urmc.rochester.edu).

We sought to estimate the number of arrestees at risk for inadequately treated drug and alcohol withdrawal in US jails. We used Arrestee Drug Abuse Monitoring Program data to estimate prevalence rates of alcohol and opiate dependence. Our results revealed rates of alcohol and opiate dependency among arrestees of approximately 12% and 4%, respectively; only 28% of jail administrators reported that their institutions had ever detoxified arrestees. Inadequately treated drug and alcohol withdrawal in US jails appears widespread. Our data raise important ethical and constitutional questions.