Crushing Medication Is Dangerous

Crushing psychiatric medication can come with serious risks. The way a medicine is dispensed is important. It determines whether or not the patient achieves any therapeutic advantage. It can also interfere with and exploit the adverse effects experienced by the patient.

So, naturally, I was upset when my loved one, an inmate at the Comanche County Detention Center in Oklahoma, told me the jail was crushing the medication of the women who are incarcerated there.

More than eight hundred people are waiting for drug treatment in Oklahoma. Many of them are in legal situations involving the court. Many of them also struggle with mental illness. My loved one struggles with Bipolar Disorder and addiction.

The Office of Diversion Control and the Drug Enforcement Administration (DEA) have policies in place which serve to protect vulnerable populations from such practice, including inmates. Oklahoma jails should be upholding the law.

The DEA Practitioner’s Manual stipulates that prescription medications are only to be given in accordance with the directions of the appropriate practitioner who has prescribing authority. Crushing tablets or opening capsules contrary to the prescribing practitioner violates the DEA’s assertion. It also places my loved one and every other inmate at risk. Because my loved one has had bariatric surgery, those risks increase even more. For bariatric patients, the “bioavailability of crushed medication can differ substantially compared to the same medication swallowed whole” (Rosko, 2011).

My friend has been in jail for over sixty days. She just saw the doctor today. On top of battling Bipolar Disorder, she has been detoxing from methamphetamine without any medical assistance. Now, she is starting new medication she has never tried before, and no attention has been given to the fact she had a Gastric Bypass and will absorb the medication at a different rate than most people. Yet, the jail can crush her pills without a written order to do so and consequently place her at risk of psychosis, suicidal ideation, stomach difficulties, cardiovascular problems, and even death.

If she wants to avoid that risk, she will have to ask the doctor to provide the jail with a written order not to crush her medication. It can take up ninety days for them to process her request to see the doctor again. In the meantime, she’s forced to consume the medicine as the jail demands. She waits for a bed. She waits for real help and real treatment. She waits with others who fight serious mental health conditions and who don’t even know their mental stability and well-being are at risk.

Like her bunkmate who takes quetiapine (Seroquel), which is crushed by the county jail. A study in 2008 confirmed a “widespread ‘abuse’ of quetiapine by inmates in the Los Angeles County Jail” (Tcheremissine, p. 740).  Quetiapine has street value and is sought out when other stimulants cannot be obtained. I wonder if workers at the Los Angeles County Jail crush the medication of their inmates without the direction of a physician, too. If so, I wonder if attempts to limit its abuse by way of presenting the drug in the exact way one would abuse it hurts or helps.

A report by Harvard Medical School confirmed that “stimulants used to treat ADHD have some potential for abuse because crushing and snorting (snuffing) them can produce a cocaine-like high” (Harvard Mental Health Letter, 2016). For inmates who struggle with addiction, I wonder how being forced to take crushed medication makes them feel. One might infer, it could and/or would trigger them back to the times they crushed medication while actively using illegal drugs.

It is one thing for Oklahoma to acknowledge that residents have a serious need for mental health and addiction treatment. It is another (completely unethical) thing to know and neglect the fact that those who are supposed to be helping fix the problem are fueling it instead and, in turn, placing themselves, the public, and our loved ones at risk.

It is unacceptable and it is dangerous. It must change. Lives depend on it.


References

Cosgrove, J (2017). Seven things to know about SQ 780, 781. The Oklahoman. NewsOK.com. Retrieved from http://newsok.com/article/5539223

Harvard Mental Health Letter (2006). ADHD update: new data on the risks of medication. Harvard Health Publications, Harvard Medical School. Retrieved from http://www.health.harvard.edu/mind-and-mood/adhd-update-new-data-on-the-risks-of-medication

Rannazzisi, J., & Caverly, M. (2015). United States Department of Justice Drug Enforcement Administration Office of Diversion Control “Practitioner’s Manual: An Informational Outline of the Controlled Substances Act” 2006 Edition.

Rosko, T. (2011). Psychiatric medications and weight gain: a review. Bariatric Times, 8(3), 12-15.

Tcheremissine, O. V. (2008). Is quetiapine a drug of abuse? Reexamining the issue of addiction. Expert opinion on drug safety, 7(6), 739-748.

Who Stands For The Victims of Daniel Holtzclaw?

While more than 600 students walked out of the classroom on Monday, 8 other women were called to the stand to testify against their accused rapist, Daniel Ken Holtzclaw, an Oklahoma City police officer.

13 women have accused officer Holtzclaw. CNHI state reporter, Janelle Stecklein reported:

A judge ordered an Oklahoma City police officer to stand trial on 35 felony charges stemming from allegations he coerced women to expose themselves, touched them inappropriately or used his authority to force them to have sex while he was on-duty.

In my home state and around the world, hundreds are standing up in solidarity with the Norman High students to address the school administration’s toleration of bullying and the revictimization and shaming of victims.

I stand with them.

In Missouri and around the world, millions are standing up in protest to act against police brutality and injustice, after Mike Brown’s family received no justice. Officer Daniel Wilson killed him with a storm of bullets. Mike was only 18, and Officer Wilson took an oath to protect him.

Officer Wilson also has a history of racism on his record.

We all stand with them.

No one is standing with these women.

In Oklahoma, if we don’t agree or the subject is too sensitive, we just bow our heads in prayer and ignore it. Even after Oklahoma court reporters, like Matt Dinger spell it out for us.

DNA found inside the uniform pants of an Oklahoma City police officer accused of a barrage of crimes matches a 17-year-old girl he reportedly raped on the front porch of her mother’s home.

You would think this case would have caused us to rise to action. You’d think, at the very least, we would share the articles and express our support for the victims and our intolerance of the abuse and violence.

But we don’t. We just remain silent, like many victims.

In the Bible Belt, that’s how you know that even Jesus couldn’t argue with the heaviness of the violence happening around us. Yet we sent in donations to show our support of rape, bullying, abuse of power and injustice.

His family didn’t remain silent.

Here’s what they had to say about the victims.

DANIEL7

DANIEL4

Yes, it makes sense. Look at Mike Brown, Tamir Rice, Trayvon Martin. Victims were interviewed because it implies tolerance and corruption in our system. Victims should never remain silent.

DANIEL5

The motive is justice. The motive is saving the next victim.

The DNA of a 17-year-old child was found inside the pants of officer Holtzclaw’s uniform.

Victims are victims until proven otherwise, too. We forget that. Never call a rape victim a liar.

Let me ask something.

I have been sexually assaulted.

Do I look like a victim?

Where is Daniel Holtzclaw now?

He walks the street as a free man while his victims are slandered on social media networks.

Tonight, I commented on the Justice for Daniel Holtzclaw Facebook page. Ten minutes later, I was blocked from the page and my comments were deleted.

I will stand.

There have been too many women, too many children and too many victims, for me to remain silent. If no one in Oklahoma will stand up for these women, I will stand for them.

They matter.