By Tracey Kaplan
Posted: 04/06/2009 12:01:00 AM PDT
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.”
Contact Tracey Kaplan at firstname.lastname@example.org or 408-278-3482.