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Santa Clara County jails cut off prescription-drug pipeline
By Tracey Kaplan
Published: 04/06/2009

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.
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