 Waste
of pills raises safety, cost issues
Inmates
fake taking their meds
By DEBORAH A. MILES
The Arthur Kill Correctional Facility is receiving
statewide media attention as staff are finding as many as
100 discarded prescription pills every day in an area
just outside the medical bay, according to reports in The
New York Times and other news organizations.
Many inmates with mental illness are spitting out their
medications, almost as soon as they get them.
Among the 970 inmates at this state prison on Staten
Island, approximately 200 receive psychotropic
medications such as Thorazine, Paxil, Neurontin and
lithium.
Without an eyewitness, it is difficult to detect which
inmates are “cheeking” — the term used to
describe when someone fakes taking their medications. But
an incident in October involving a PEF member brought
more attention to the problem.
According to Peter McDonald, PEF Division 318 council
leader and a correctional counselor at Arthur Kill, an
inmate whose behavior was documented as
“bizarre” by three staff members struck a
psychiatrist in the face with his fist. The inmate
attacked the PEF member after being told he was being
transferred to the special housing unit, known as
“the box,” for his own protection. It took
three correctional officers to restrain the inmate.
McDonald also said there is no way of knowing if this
inmate discarded his medication, and if that was the
reason for his bizarre and subsequent violent behavior.
“By law, we can’t force an inmate to swallow.
This has been an ongoing problem especially with those
who are on antipsychotic drugs. Arthur Kill is designated
as a state Office of Mental Health unit. We get a lot of
those people,” he said.
What an inmate
can control
“When inmates discard their medications, it poses
safety and financial problems,” said PEF Region 11
Coordinator Jemma Marie-Hanson. “When I visited
Arthur Kill in November, the pills were on the ground and
they were very visible.”
Marie-Hanson, who is also a registered nurse, said when
an inmate wants to conceal and discard medication, it can
easily be done with pills.
“It’s the only situation inmates can control,
because they are incarcerated. If they verbally refuse to
take their medications, which they may do, they also know
there are consequences. It’s easier to say,
‘I’ll take my meds,’ and then discard
them,” she said.
Katrina Howard, PEF’s nurse organizer, added,
“If a patient refuses to takes meds, it is
documented by the nurse. Many won’t verbally refuse
them because they know they will be placed under tighter
scrutiny.”
Ways to stop ‘cheeking’
One alternative would be to dispense the medications in
liquid or dissolvable form, a recommendation being pushed
by the Arthur Kill corrections officers and Assembly
Member Michael Cusick of Staten Island. They are pressing
for a state law requiring the Department of Correctional
Services (DOCS) to dispense psychotropic medications in
liquid or dissolvable form to prevent inmates from faking
their ingestion.
However, liquid medication may not be the panacea for
this problem.
“What if we give an inmate liquid medication and he
spits it on our people?” asked Tom Donahue,
PEF’s labor-management chair for DOCS. “That
would create a health issue and another problem to
address. This would also be more time-consuming work for
our members, as they would have to measure out the
doses.”
“Thorazine, Paxil, Neurontin and lithium are all
available in liquid form,” said Deborah Egel, PEF
co-chair of the statewide nurse’s committee and a
mental health nurse. “But these drugs are more
expensive in liquid form and less stable, because it is
more difficult to make these medications time-sensitive
in liquid form.”
Egel recommended dissolvable pills. “The minute you
put them on your tongue, they dissolve. That would be the
best solution,” she said.
However, many psychotropic drugs are not yet available in
dissolvable or “wafer” form.
Short-staffing plays a role
Arthur Kill has also been affected by the statewide
short-staffing crunch. There are only five nurses and one
nurse supervisor tending the nearly 1,000 inmate
population.
“There’s no quick fix. When you run
short-staffed, you have problems,” Donahue said.
“This is a tough one for us.”
Along with being a safety issue for inmates and staff,
the cheeking epidemic at Arthur Kill may be costing
taxpayers hundreds of wasted dollars. No one, as yet, has
placed a price tag on the number of discarded pills being
trashed.
McDonald said the labor-management team is investigating
the problem and a good level of cooperation exists.
Whether or not this is an isolated situation needs
further investigation.
“From conversations I’ve had with members at
other facilities who also deal with mental health
patients, they have had some problems with inmates
cheeking, but not to the extent that has surfaced at
Arthur Kill,” Donahue said. “Statewide research
needs to be done to determine if this is a system-wide
issue. We don’t know the extent of the
problem.”
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