Pubdate: Mon, 06 Apr 2009
Source: San Jose Mercury News (CA)
Copyright: 2009 San Jose Mercury News
Contact:  http://www.mercurynews.com/
Details: http://www.mapinc.org/media/390
Author: Tracey Kaplan
Bookmark: http://www.mapinc.org/prison.htm (Incarceration)

SANTA CLARA COUNTY JAILS CUT OFF PRESCRIPTION-DRUG PIPELINE

Inmates desperate to get high still rely on an old standard - pruno -
a potent prison wine concocted from hoarded fruit and ketchup using
the water in cell toilet bowls. Street drugs also regularly get
smuggled past guards by wily visitors.

But the latest way to get stoned behind bars has been Seroquel and
Wellbutrin, expensive psychotropic drugs that inmates obtain by
pretending to be schizophrenic or depressed. Santa Clara County's tab
last year for the two drugs: $614,000 at a time when the county is
facing a $220 million deficit.

Now, Santa Clara County and scattered jails around the nation are
battling what they say is rampant abuse of the two powerful drugs by
refusing to prescribe them - except in what they deem as "special cases."

"There are other drugs that are just as good and can save us money,"
said Joy Alexiou,? spokeswoman for the Santa Clara Valley Health and
Hospital System.

Corrections officials throughout the country have long suspected that
some inmates were either using the pills to get loaded, or "cheeking"
them in order to later sell them to other prisoners to chop up and
snort. Seroquel is an anti-psychotic that produces a hypnotic effect,
and Wellbutrin is an antidepressant some liken to speed.

Even as the cost of the two drugs mounted, corrections officials
hesitated to stem their use, fearing inmates might sue on the grounds
they were being denied necessary prescription medication.

But as the legal fallout remained negligible, larger jail systems
began limiting the drugs. By August, for instance, the California
state prison system had largely ceased their distribution.

Attorneys with The Public Interest Law Firm, a San Jose nonprofit that
often represents inmates in class-action suits, said the group has no
immediate objection to Santa Clara County's new policy, as long as the
decision to withhold the drugs is made on a case-by-case basis.

"It should be made based on individual treatment history and the
history of substance abuse, not on cost savings," said Kyra A.
Kazantzis, the group's directing attorney.

The county's move follows a landmark Fresno County study presented
?last month at the Forensic Mental Health Association's convention in
Seaside that is likely to embolden more jails.

Co-author George Laird, the Fresno jail's lead clinical psychologist,
said he and psychiatrist Dr. Pratap Narayan noticed in summer 2007
that many inmates who demanded Seroquel didn't exhibit classic signs
of mental illness but refused to accept a substitute medication. The
doctors also researched the Web and found chat rooms where former
inmates and others openly discussed getting high off both drugs.

"It definitely goes on," said John Madsen, secretary of the California
Association of Alcoholism and Drug Abuse Counselors. "Say someone is
addicted to cocaine but can't get it. They'll try the next best thing.
When it comes to drugs, addicts will find themselves doing just about
anything."

Fresno found no demonstrable harm to inmates by not prescribing the
drugs, Laird said. There was no increase in crisis calls, suicides,
transfers to padded safety cells or emergency placement in psychiatric
units, he said.

Jail doctors prescribed more anti-depressants, Laird said, because
Seroquel abuse was masking underlying depression. But those
anti-depressants are far less expensive. Fresno was spending about
$95,000 a month on psychotropic drugs of all kinds in July 2007. By
April 2008, after the drugs were eliminated, that expense had fallen
to only $17,000.

"Our goal wasn't a financial one. It was to cut down on abuse," Laird
said. "Now, it's almost embarrassing. It really revealed what the
abuse was costing us."
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MAP posted-by: Larry Seguin