Carmela Devargas did not have to die

On Nov. 9, about two weeks after being transferred to the hospital from the Santa Fe County Detention Center, Carmela succumbed to meningitis and was taken off life support, according to newspaper reports.

She was incarcerated on Sept. 19 for a probation violation. Her father said she started feeling ill with high fevers around the beginning of November. For almost a month, family members allege that she was denied adequate medical attention. The guards mocked her as her health deteriorated. They told her she was just “kicking,” street lingo for the symptoms of opioid withdrawal. They taunted her and ignored her pleas for medical attention, instead telling her to “shoot up more heroin.”

Finally, after she was no longer able to breathe on her own, they relented and took her to the hospital. By the time she arrived, she was paralyzed from the neck down due to an abscess near her spinal cord. Even so, reports state that the guards insisted on shackling her to her bed to prevent her from escaping. It was a difficult end to a life of suffering.

Carmela turned to drugs to numb the pain from the trauma that filled her life. She was in and out of jail 13 times for drug- and alcohol-related offenses. Many times, she tried to get help to get off the drugs, but she couldn’t get a break. At several points, she entered rehab determined to get better, but was kicked out for a relapse. She endured her mother’s early death from cancer and domestic violence, but the last blow might have been the loss of her kids to foster care as she struggled with her addiction.

If we had a behavioral health care system and trauma-informed medical care accessible to all, she might not have died. If we had accessible treatment for drug and alcohol dependence with an understanding that relapse can be part of the path to recovery, that didn’t give up on people and met them where they are, she might not have died.

If we had a justice system that did not criminalize drug possession, she might not have died.

If we had a child welfare system that worked to address the trauma of whole families and had the resources to help them reunify, she might not have died.

And most of all, if we provided humane medical care and treatment for drug and alcohol dependence in our county jail, she would not have died because her symptoms of meningitis would not have been confused with those of withdrawal.

Carmela’s case isn’t an isolated incident. I often hear stories from my patients about the treatment received at the Santa Fe County Detention Center. Over the past 10 years, the jail has been the subject of lawsuits and investigations into several deaths and injuries resulting from inadequate medical care.

Improving our behavioral health system and overall medical care in the jail might be tall orders, but there is one simple thing the jail could start doing tomorrow that would dramatically decrease the risk of death for those incarcerated.

For many years, a group of advocates for drug and alcohol treatment have pleaded with Santa Fe County to allow access to opioid dependence treatment in jail. Over and over we have been told that those in charge are too afraid that Suboxone and methadone, the medications used to treat opioid dependence, would be diverted from their intended use. They are afraid that prisoners will use them to “just get high.”

We have seen reports of how jail staff regard the treatable medical condition of opioid withdrawal, mocking those with symptoms and denying them relief or access to effective medication. Withdrawal itself is not a benign condition. People in withdrawal suffer tremendously. Complications like lung infections from aspirating vomit, dehydration and electrolyte imbalances are common.

For those who have other health problems, withdrawal can be life-threatening. As in Carmela’s case, withdrawal symptoms can be confused with more serious conditions. Forcing someone go through withdrawal without proper medical treatment is a form of torture.

Santa Fe County changes its policies? If we had answered that question humanely before last November, Carmela Devargas would not have had to die.