During the last two years, there were more than a half-dozen deaths involving heroin withdrawal in jails across the United States. The incidents prompted lawsuits and outrage from harm reduction advocates who fear the number will grow given the nation’s heroin crisis, CBS News reports.

Opioid withdrawal, while painful, is rarely life-threatening if medical attention, monitoring and intravenous fluids are available. But the severe vomiting, diarrhea and electrolyte imbalances that result when the body detoxes from heroin can trigger serious health issues, such as dehydration and unconsciousness, in those who aren’t properly cared for.

Recently, legal advocates in Philadelphia filed a lawsuit against a jail in central Pennsylvania on behalf of Stephanie Moyer, whose 18-year-old daughter, Victoria Herr, died during heroin withdrawal while incarcerated at the Lebanon County Correctional Facility.

Last year, a similar lawsuit detailed the suffering of a man named David Stojcevski who lost 50 pounds and died during a one-month stay in jail after getting slapped with a fine for careless driving. Jail video showed Stojcevski as he struggled naked on a stone floor undergoing withdrawal from methadone, prescription opioids and the anti-anxiety drug benzodiazepine. (Similar cases in Oregon and Colorado also prompted lawsuits and made the news.)

Advocates stressed that authorities could have prevented each of these deaths if the jails afforded inmates proper medical care and methadone maintenance while they underwent withdrawal. But the reality is that many smaller lockups across the country lack in-house medical units or sufficient staff to monitor people struggling with addiction. The result, claimed lawyers in these cases, may amount to cruel and unusual punishment, a violation of inmates’ constitutional rights.

“Obviously, this is an emerging, growing problem and it’s hitting communities all over the country,” said civil rights lawyer Emma Freudenberger, a co-counsel on Herr’s lawsuit. “That’s exponentially so in jails.” In addition, she suggested that some jailhouse authorities might lack concern for people struggling with addiction.

Click here to learn more about incarceration, addiction and the importance of medication assisted treatment in U.S. jails and prisons.