When Withdrawal Becomes a Medical Emergency

This story is based on real risks police officers face in Liberia. It illustrates how substance dependence can quickly become a medical emergency in custody — and how timely action can save a life..

Every day, officers of the Liberia National Police intercept illegal drugs. But what happens when the suspect is also dependent on those drugs? This is the story of Musa..

It is nighttime at a road checkpoint near Monrovia. A police officer signals a yellow keh keh to stop after the driver abruptly crosses lanes, nearly colliding with a police vehicle. The driver is Musa Kanneh — a man in his mid thirties, an ordinary Liberian trying to make a living..

The Encounter. Nighttime road checkpoint near Monrovia. Musa Kanneh (mid-30s, ordinary Liberian everyman) is pulled over by a police officer while riding his keh-keh (a tricycle popularly used for commercial transport in Liberia). He was pulled over for abruptly crossing lane, almost crashing into the police vehicle. Upon questioning, the officer asked to search his back pad. Officers find packets of heroin in his back pad..

[Audio] During questioning, the officer requests to search Musa’s backpack. Inside, officers discover several packets of heroin. The arrest is conducted quickly and professionally. Musa appears calm — but he is sweating heavily. In a low voice, he mutters: “Officer… I need help. That is my medicine. Please give it to me.” The officer responds firmly:.

[Audio] During questioning, the officer requests to search Musa’s backpack. Inside, officers discover several packets of heroin. The arrest is conducted quickly and professionally. Musa appears calm — but he is sweating heavily. In a low voice, he mutters:.

[Audio] “Officer… I need help. That is my medicine. Please give it to me.” The officer responds firmly: “You are under arrest for drug trafficking under the Narcotic Drugs and Substances Use Act. The drugs will be seized as evidence, and you will be taken to the police station.” Musa is handcuffed and placed into the police vehicle..

[Audio] Every day, police officers intercept illegal drugs. But when a suspect is dependent on those drugs, the situation can become life threatening..

[Audio] At the police station in Monrovia, Musa is processed. He is fingerprinted, searched, and placed into a holding cell to await court the next day. He appears anxious, but cooperative. An officer records in the logbook: “Suspect claims he is a user.” The cell door closes..

[Audio] The lights dim. From inside the cell, Musa calls out: “Officer! Please help me!” But the officers continue their duties..

[Audio] Several hours later, during the night, Musa begins to feel unwell. He starts sweating heavily. His body begins to shake. He vomits into a bucket. He complains of severe cramps. He becomes restless and anxious. These are classic signs of opioid withdrawal..

[Audio] Heroin is one of the most common drugs associated with severe withdrawal symptoms — and without treatment, these symptoms can become life threatening. Musa paces inside the cell. He bangs weakly on the door. His voice trembles. “Officer… please… I am sick. I need my medicine. I will die without it.” The officer on night duty looks through the cell hatch. “What is wrong with you?” Musa replies desperately: “Please… I need the drugs you seized. Just a little bit to stop this. I will cooperate. I am very sick.”.

[Audio] The officer calls a senior colleague. Both officers stand outside the cell discussing the situation. Inside, Musa continues begging: “Please… just a small amount. I will be okay.” The officer responds professionally and firmly: “We cannot give you any drugs. That would be illegal and against police policy. We do not supply narcotics to anyone.” The senior officer adds: “You must wait until court. We will note your condition.” Musa slowly collapses against the cell bars. He is exhausted. He begins to cry..

[Audio] “You don’t understand… my body is shutting down.” The officers walk away, following the rules — but uncertain about what to do next..

[Audio] By the next day, Musa’s condition has worsened. He is curled on the floor. He is dehydrated. He is confused. At times, his body shakes violently. Officers check on him periodically. Some believe he is exaggerating..

[Audio] Others assume he is simply seeking drugs. No medical call is made. A younger officer looks concerned. Quietly, he asks: “Should we take him to the hospital?” The senior officer replies: “He will be fine once he goes to court. He is pretending.” The cell door remains locked..

[Audio] The following morning, officers arrive to transport Musa to court. They unlock the cell. Inside, Musa lies motionless on the floor. An officer rushes forward. “He’s not breathing!” Panic spreads. Officers attempt C-P-R-. A radio call is made for an ambulance. But it is too late. Musa is pronounced dead after two days in police custody..

[Audio] Key Learning Message Heroin withdrawal is a real medical emergency. It can cause: Severe dehydration Seizures Organ failure And death — if untreated Musa’s request for the seized drugs was correctly refused. Police must never supply or facilitate illegal drugs. However, another action was required. Medical care..

[Audio] What Should Have Happened Here is what should have happened. First: Immediate medical assessment. Every detainee has the right to urgent medical care under the Constitution, the Police Act, and international human rights standards. Second: Recognize the signs. Sweating Shaking Vomiting Severe cramps Restlessness.

[Audio] These are signs of withdrawal — not misconduct, and not “faking.” Call the station medical officer or ambulance immediately. Third: Do not delay. Transfer the detainee to a hospital — such as Grant Hospital — for supervised treatment. Provide supportive care, including hydration and monitoring, while awaiting professional help. Fourth: Document everything. Record the symptoms. Record the request. Record the actions taken. Fifth: Follow best practice. Screen for substance use at the time of arrest. And apply a clear protocol: Suspected withdrawal? Medical referral — immediately..

[Audio] Final Closing Message Withdrawal can kill. But timely action can save lives. Recognize the signs. Act quickly. Protect life. Fulfill your duty of care..