For many, the idea of opioid addictions in the prison system isn’t typically at the top of most people’s list of concerns. However, with the prison population continuing to rise, it has become a serious issue in many states. For this reason, the San Diego County jail has opted to discontinue using opioids as a method for pain relief for their inmates.
Drugs in Jail
It is no secret that drug use in jails and prisons is somewhat unavoidable. Despite secure facilities and random searches, illegal drugs still manage to make their way into the population. That being said, prescribed opioid medications don’t have to add to the mix.
The San Diego County Jail has made an effort to reducing addiction rates in the prison system and keeping drug trafficking inside its walls to a minimum by eliminating the availability of prescription opioids to non-essential inmates.
For example, In the month of March, only 23 inmates, including those with cancer, were prescribed an opioid medication. In comparison, in 2013, over 1,000 inmates were prescribed an opioid pill. Over those 1,000 inmates, 77,000 opioid pills were administered annually
In order to ensure that the opioid prescription rate stays low, the county jail has put in place specific requirements that inmates must meet if they are to be prescribed opioid painkillers.
- new inmates must have a current prescription written by a consistent provider
- That provider must provide a current, chronic pain diagnosis
- Inmates who are warranted opioid medications must undergo counseling of the inherent risks and dangers that come from opioid pills.
- Inmates who receive opioid prescriptions are observed taking their medication by staff to ensure that they do not “cheek” their pill or give it to another inmate
- If an inmate is found to violate their requirements, they could be taken off of their opioid medication and given a non-narcotic alternative
While the prison system acknowledges it has not completely ruled out the option of using opioid medications for inmates who require them, it does state that the selection process has become much more in depth.
This has been shown to be extremely beneficial for the prison population as a whole, as is obvious by the reduction of opioid use in the jail, and many inmates report realizing that continuing or starting a prescription for opioids, “does a lot more harm than good,” reports Dr. Alfred Joshua, the Sheriff Department’s chief medical officer.
That being said, the county jail is not trying to keep all inmates off of opioids. On the contrary, they understand that some medical conditions that produce chronic pain simply respond better to opioids, and results in better quality of life for those patients.
For example, patients who are given a non-narcotic alternative to pain medications are closely monitored by medical staff. “When patient function remains poor and pain is not well controlled, and other options have been exhausted, a therapeutic trial of medication, including opioids, should be available,” wrote the National Commission on Correctional Health Care in their pain management guidelines.
As with any change to a major system, there are wildly varying opinions to its outcomes. Many inmates have reported the elimination of opioids to non-necessary patients as having “gone too far”.
Some inmates have even filed lawsuits against the county jail for reportedly “cruel and unusual punishment” although none have succeeded in court as of yet. This is because the inmate must prove that they had a serious medical condition that was purposely ignored or responded indifferently to. Thus far, none of those inmates have been able to prove that evidence.
According to U.S. Magistrate Judge Ruben Brooks, “an inmate does not have a constitutional right to choose his own medication… if medical personnel disagree on the course of patient treatment, subsequent health care providers are not deliberately indifferent when they choose one treatment over the inmate’s wishes.”
With the current rate of opioid addiction in the U.S., and with three quarters of the San Diego County inmate population having reported a previous substance abuse habit, it makes sense that unnecessary access to opioid pills would be the first step on the journey to change.
Opioids in the Population
The executive director of the Prison Law Office, which is a California based non-profit organization that advocates for the well-being of inmates and prisoners in the state have reported no objections to this new change in opioid policy.
The organization has been closely monitoring it since it’s beginnings in 2014 and thus far, generally agree with the guidelines and necessity of it. The executive director of the organization, attorney Donald Specter, admits that this change is a positive step forward for the overall inmate population.
“I think generally now there’s a recognition in the community about the dangers of opioids, the same guidelines in effect in the community should also be present in the prisons,” he states.
On average, around 1000 “drug incidents” are reported in the state of California prisons, annually. This could mean anything from seizures of drugs in the prisons ranging from marijuana to cocaine to heroin to meth. Between the years 2006 and 2008, 44 California inmates died of a drug overdose.
This is not surprising news, as prisons have been reporting more and more contraband flooding through the walls every year through a combination of complicit visitors, corrupt staff members, and smuggled cell phones. With every other area of drug use on the rise among prison systems throughout the nation, it makes complete sense to limit access to addictive chemicals when possible and available.
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