The Kensington community remains shaken following the fatalities of Amanda Cahill and Joey Gabor, both of whom passed away in custody shortly after their arrest during the area’s contentious narcotics sweeps at the conclusion of 2024. While the specific circumstances surrounding these deaths remain unclear, they are distressing and illustrate the precarious situation of individuals confined with substance use disorders. As medical professionals dedicated to addressing the opioid crisis, we must advocate for enhanced access to healthcare within prisons for some of our most at-risk patients to prevent further tragedies.
On September 4, a 31-year-old mother of two was apprehended during a sweep in Kensington carried out by the Philadelphia police. She was transported to the Philadelphia Industrial Correctional Center and died in the early hours of September 7. Although the cause of death is still undetermined, she is among over 20 individuals who have died while in custody within the Philadelphia prison system, as reported by the Inquirer. On December 12, another unfortunate incident took place when Joey Gabor, a 41-year-old Fishtown resident, was arrested in Kensington on December 11 and later found unresponsive on December 12 before being pronounced dead. Drug paraphernalia was allegedly discovered near his remains, amplifying ongoing concerns regarding understaffing and oversight within the jail and prison systems.
The criminalization of addiction has persistently been an issue throughout the United States, bearing severe consequences for affected individuals. A class action lawsuit was lodged in 2020 against the Philadelphia Department of Prisons and the city, alleging inhumane conditions. Following a settlement agreement in 2022, the city of Philadelphia was mandated to pay $25 million after being found in contempt of that agreement. The state of Philadelphia prisons has been extensively documented by the Pennsylvania Prison Society, an organization committed to reporting prison conditions. As recently as August 2024, their report highlighted insufficient meal portions, inadequate time outside of cells, and physical plant issues, including excessive heat and leaking pipes. Another notable finding was a reported wait time exceeding one week for requested medical care. Concerns about short-staffing and perilous conditions continue, despite years of initiatives aimed at creating change, and the latest deaths underscore the urgent need for substantial improvements.
It is ethically questionable to penalize conduct arising from illness, and the recent events in Philadelphia emphasize the serious consequences of arresting individuals for using illicit substances without a system that provides timely and effective medical care. Punitive approaches are ineffective in treating substance use disorder and can lead to significant morbidity and mortality during the initial intake and upon release. Data from 2009 indicated that half of the individuals in prison had an undiagnosed and untreated use disorder. Following their release, individuals face a markedly increased risk of drug overdose, with research indicating a tenfold higher risk compared to the general population. We understand the hazards of criminalizing substance use. Yet, a system for safely treating individuals arrested for illegal substance possession due to a substance use disorder or an alternative to incarceration remains absent.
“Deliberate indifference to the serious medical needs of prisoners” was found constitutionally prohibited in a 1976 Supreme Court ruling. Nevertheless, apart from these vague terms, there are no standardized or regulated healthcare protocols across U.S. prisons or jails. Organizations such as the National Commission on Correctional Health Care establish care standards and provide accreditation; however, federal, private, and state facilities are governed by a variety of federal, state, and county regulations. Individuals with substance use disorders fare even worse due to the inadequate treatment of their condition while incarcerated.
Ultimately, we may not be privy to all the details regarding Amanda Cahill and Joey Gabor’s situations. Still, their tragic deaths highlight the critical need for improved access to medical care within prisons for our most vulnerable patients grappling with this epidemic. Ensuring access to addiction-medicine-trained physicians who can aid with withdrawal and initiate medications for opioid use disorder (MOUD) while incarcerated can be a significant step forward.
The physicians and medical students at Doctors for America continue to advocate for patients facing substance use disorders and urge our lawmakers to join in that effort.
Kendall Major, Tommy Gautier, Alyssa Lambrecht, and Elle Saine are members of the Doctors for America Substance Use Disorder Subcommittee.