Pubdate: Wed, 23 May 2001
Source: Register-Guard, The (OR)
Copyright: 2001 The Register-Guard
Contact:  http://www.registerguard.com/
Details: http://www.mapinc.org/media/362
Author: Joe Mosley, The Register-Guard
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

JAIL STOPS METHADONE TREATMENT FOR INMATES

Inmates using methadone to treat heroin addiction before their
admissions to the Lane County Jail can no longer receive the
medication while they are incarcerated, medical officials at the
lockup said Tuesday.

"None of us want this to be, but it is a question of how we have
identified the priorities," said Dr. John Allcott, the jail's medical
director.

The jail's difficulty recruiting nurses in a tight job market has left
its staff three positions short, and the administration of methadone
is a time-consuming task that remaining nurses can no longer carry
out, said Allcott and jail nursing supervisor Linda McCarver. The
federal Drug Enforcement Agency requires strict accounting practices
for methadone, which means extra paperwork and time demands for jail
nurses.

Just two years ago, the jail's daily inmate population averaged two or
three methadone patients, McCarver said. The average had risen to
between five and 10, and it was expected to rise again after the
number of local methadone clinics doubled in recent months to a total
of four.

"That was the straw that broke the camel's back," McCarver
said.

In lieu of methadone - a synthetic substitute drug that helps heroin
users ease out of their addictions - the jail has placed methadone
patients under its "opiate withdrawal protocol" for treatment of
heroin addicts. Imates are given other medications to treat symptoms
they encounter during a two-to four-day withdrawal period.

Local methadone clinics were informed two months ago of the jail's
impending policy change, which went into effect last week.

Kristy Murray, a therapist at CODA Addiction Treatment Services in
Eugene, said she understands why the jail's medical staff found the
change necessary. But she said it is not in the best interest of
inmates hoping for long-term success in battling heroin addiction.

"We respect their prerogative to provide treatment as they see fit; I
don't want to make it sound like we're in conflict with them in any
way," Murray said. "But it's like somebody who's taking an
antidepressant. It's something that helps reorganize a person's brain
chemistry. So to take that away from somebody or deny somebody of
that, it's a dilemma."

Tricia Hedin, a lawyer for the Public Defender Services, said her
office learned of the change only after clients complained.

She said there is a question to be answered about whether a
prescription issued to treat someone for a disease - in this case,
addiction - can legally be ignored by jail staff.

Hedin also maintained that disruption of methadone treatment will
likely send many inmates back to heroin addiction after they are
released from jail, because methadone treatments cannot be stopped and
then restarted.

"The policy doesn't make sense, in terms of community safety," she
said. "And I know this community has spent a long time trying to get a
handle on the heroin problem."

Allcott, the jail's medical director, said the policy is more of a
medical issue than a legal one.

The nursing staff evaluates the medical situations of all inmates and
sets priorities based on who has the greatest needs, he said. Regular
medication for diabetics, heart patients and those with psychotic
conditions is a top priority, but many with lesser medical needs -
anything from chronic headaches to arthritis - must go without their
regular medications while in jail.

"It's sort of a medical-phamacologic triage," Allcott said. "Those at
greatest risk, we are able to concentrate on their needs."

If the jail can fill all of its vacant nursing position, officials
said, they would consider resuming the methadone treatment.
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MAP posted-by: Terry Liittschwager