$25K quarterly county jail pharmacy tab
Suboxon detox for some, Codeine detox for most?
Neither a RANT nor a RAVE, but a note of sincere thanks and appreciation to the four physician assistants, seven
psychiatric nurses and two addiction treatment professionals who reviewed a long list of all medications prescribed at the
Fayette County Prison during the first quarter of 2018.
As per county documents obtained under a Right To Know request from Uniontown citizens Bill and Kathryn Jones and
graciously shared with Rants&Raves, Fayette County paid $25,634.80 for a three-month Pechin's Pharmacy tab for those
incarcerated at the county jail.
Of the total 1,095 prescriptions that the county bought for inmates for the first quarter of 2018:
- 487 were for psychiatric medications
- 4 were for 135 doses of Buprenorphine, a generic Suboxin used to detox from heroin and opioids
- 24 were for 2,070 doses of the opioid Acetaminophen with Codeine3
- 33 were for 1,620 doses of various muscle relaxers
- 547 were for medical health care (diabetes, cardiac, skin, respiratory, antibiotics, some medical supplies such
as pregnancy kits, support hose, nail clippers, etc)
"We accompany medical staff so they can dispense medications," said one county prison corrections officer who also
reviewed the pharmacy purchase lists.
"There really are a lot of medications to dispense," he said of the 100 or so printed page list, estimating that rounds to
dispense medications at the jail can sometimes take up to three hours to complete.
Another corrections officer agreed that the list of medications is indeed a long one for the small jail said to be at its lowest
population in some time. He shared concerns that some inmates are so strongly medicated at night and drop off right
away to sleep that they sometimes refuse their daytime medications to be awake and more alert during the day.
While the county paid for 135 doses of Buprenorphine, the generic Suboxin and Subutex opioid, the correction officers
who spoke with Rants&Raves said they had no knowledge that it was used at the prison. One correction officer, however,
said that he is aware that Codeine3 is prescribed and used inside the jail for detox.
A Right To Know request was submitted to the county to learn if the 135 doses of Buprenorphine Suboxin were
prescribed and shipped to someone jailed in Fayette but incarcerated in a cell rental agreement with Greene County or
another out of county jail.
"From the high number of Codeine3 doses purchased in 12 weeks for a small jail with about 200 inmates, I would assume
the jail has to be using Codeine3 to detox inmates and detainees with opioid addictions," one physician's assistant said.
Usually, he explained, addicts trying to detox themselves at home or outside a professionally run treatment facility take
Codeine3 as a heroin or opioid detox only for no longer than three weeks.
"They detoxing themselves normally take it in decreasing amounts with an end date firmly in mind before a Codeine3
detox starts," he said. Most of those he has heard of personally doing that did not accomplish their goal to detox from
heroin with Codeine unless the person had strong support from friends or family.
"Basically, he or she would have to have a strong friend to hold the Codeine for them," he said.
In other words, the daily use of Codeine3 long-term at the same dosage on the same inmate, in the professionals' opinion,
is helping the inmate to remain being an addict.
Although withdrawal from Codeine3 is said to be less traumatic than heroin withdrawal is on the addict, he said he knows
of no reputable opioid addictions program that uses Codeine as part of the regular heroin or opioid withdrawal process.
"Codeine is a narcotic pain reliever that converts to morphine in the brain," the physician's assistant explained as the drug
binds itself to opioid receptors. None of the professionals involved in this project would call the county foolish or negligent
for using so much Codeine and so little Suboxin or other drugs typically dispensed at methadone clinics, but said it was
not a wise choice in the long run for any county wanting to reduce recidivism and repeat incarcerations.
Our professionals who reviewed the county's jail pharmacy purchase list for the first quarter of 2018 -- like we who ask
RTK questions and get no real answer -- do not know how many different inmates received the prescriptions since
redaction of the RTK answer blocked the release of patient names for privacy.
Nor are any of us certain that the 30, 60, 90 or 120-count pill prescriptions are for a two or four week period or longer.
The only thing that everyone involved agreed on is that a tiny jail, with so much psych medication, opioids, muscle
relaxers and Melatonin prescribed, should be fairly quiet and sedated most of the time.
There should be nobody in moods to rally and riot, as county prison staff and inmates have said in writing to
Rants&Raves, that certainly had been the case in early spring.