Guest blog from AzPHA member Andy Hall, MS, PhD
Many are aware of the class-action litigation over healthcare in Arizona’s prisons that began in 2012, and many know that the system’s healthcare program was recently placed in receivership after years of failure to meet Constitutional standards. Meanwhile, a healthcare crisis in the Maricopa County Sheriff’s Office (MCSO) jails has gone largely unnoticed.
I paid the jails no attention until the Arizona Republic ran a piece in August 2024 by Jimmy Jenkins titled “Dying in the Dark.” Jenkins looked at the numbers, identities and causes of death for everyone who died in MCSO custody from 2019 to 2023. He found that although the average daily population (ADP) in the jails had declined, deaths had risen dramatically over that five-year period.
Investigation finds ‘astronomical’ death rate in Maricopa County jails
Indeed, the number of deaths in the jails had nearly quadrupled in the most recent three years. Office of Medical Examiner (OME) autopsies showed that 43 people (most awaiting trial) died in MCSO custody in both 2022 and 2023, far higher than the 2019 total of eleven.
Moreover, the numbers from those two years led to the finding that Maricopa’s rate of jail deaths was four times higher than the national average. And, astonishingly, drug overdoses, withdrawals and suicides were found to account for the majority of those deaths.
Jenkins’ findings were so eye-opening that I began tracking the Sheriff’s monthly inmate deaths listings and requesting autopsies from OME. While numbers of jail-attributable deaths have been a tad lower since 2023, the autopsies continue to tell a very troubling story.
In 2024, MCSO listed 27 deaths. Knowing that might not be the whole picture, I asked OME for a review. That review found seven jail-attributable deaths not counted by MCSO, for a total of 34 jail deaths that year. For 2025, MCSO’s listing showed 39 deaths. OME added two cases, for a total of 41 deaths last year, 75 over the two years.
Behind the totals, OME autopsies continue to show extremely high numbers of “accidental” drug intoxication deaths, accounting for 46% (16 of 34) of 2024 deaths and 51% (21 of 41) of 2025 deaths. One-third of 75 deaths over the 2024-25 period were determined “natural” by OME examiners. This means that the remaining two-thirds, whether accidental, suicide or homicide, were preventable.
While the accidental death numbers are extremely troubling, close reading of the autopsies reveals an even more distressing aspect — the number of people who die very shortly after booking, some within hours.
In both 2024 and 2025, many accidental drug deaths occurred within the first 48 to 72 hours after people entered the jail system, raising urgent questions about intake screening, withdrawal management, monitoring, and emergency response.
In 2024, ten of the sixteen drug deaths happened within 72 hours of admission. Likewise, ten of twenty-one 2025 accidental deaths occurred very shortly after booking, several within 48 hours. The OME reports are terribly disturbing to say the least. What’s going on?
Maricopa County Corrections Annual Report
In a recent interview on jail overdose deaths, Sheriff Jerry Sheridan stated that in his 40+ years at MCSO, he knew of only two cases of staff bringing drugs into the jails. He said, “..there are drugs in the jail system and that’s just the way it is in every jail and in every prison in this country.” Since, in his view, drug deaths simply can’t be blamed on MCSO staff, the Sheriff has removed the scanners used by his predecessor to screen employees.
County jail overdose deaths are up as sheriff defends removing employee scanners
Amid all these deaths (161 from 2022 through 2025, with the overwhelming majority accidental and otherwise preventable), Correctional Health Services (CHS) is responsible for providing a full continuum of care from intake through release in the County’s jails.
In the CHS 2025 Annual Report, Director Lisa Struble boasts of three 2025 National Association of Counties Achievement Awards, claims the CHS Opioid Treatment Program serves as a national model, and states CHS will continue to “set the standard for excellence in correctional healthcare.”
And yet, Struble’s report makes absolutely no mention of deaths occurring in the Maricopa County jail system! With a death rate found two years ago to be far higher than other large metro jail systems, such LA County, New York’s Rikers Island, Cook County, Illinois, and Harris County, Texas, CHS simply cannot credibly claim to set any kind of “standard for excellence” in jail healthcare. Ignoring the problem won’t make it go away.
140 Dead in Los Angeles Jails Since Start of 2023 | Vera Institute
Sheriff Sheridan and Ms. Struble are in denial. Meanwhile, a hell of a lot of people are dying. Immediate investigation is needed to understand why accidental deaths and suicides in our jails are so high and to figure out what must be done to address this true public health crisis.
– Andy Hall, MS, PhD, is retired after a varied career in progressive criminal justice advocacy, voting rights, prisoners’ rights, death penalty mitigation, academia, and technical support for homeless and domestic abuse services. He lives in Tempe. Email j.andyhall@gmail.com.