English Prisoners win rights to Opiates for Withdrawal in Jail

*Six prisoners and former inmates forced to stop taking drugs by going “cold turkey” are to receive payments, sources at the High Court have said.

The unspecified settlement followed claims the practice amounted to assault and a breach of human rights.

The claimants had been using heroin and other opiates.

They were said to have been receiving alternative treatment before coming under the responsibility of the Prison Service in England and Wales.

They said once inside they were then made to go “cold turkey” which means the drug was suddenly withdrawn or cut short and they faced detoxification. *

Is this a good idea or something that you oppose.

I welcome it as a reinforcement that drug addiction should be treated as an illness and not as a crime.

What is your opinion?

Good, I’m glad they won. Having been there, Opiate withdrawal is no picnic.

I can see the Daily Mail and Daily Express having a field day over this . They will pander to the masses who have no knowledge of how difficult coming off drugs can be. More money must be invested in proper drug rehabilitation measures in prisons.

In the US, it is actually illegal to prescribe opiates to maintain an addiction or to prevent withdrawal.

Exceptions include use of methadone to detox from or maintain an addiction to opiates, or the use of buprenorphine for the same purpose. Both these drugs require special extra education, licensure, and certification to use for addiction maintenance or withdrawal in this country. I’d guess that fewer than 1 in a thousand docs in the US have the certifications necessary to prescribe either of these drugs to treat opiate addiction. (Any doc with a DEA number can prescribe methadone to treat pain. But if he’s caught treating addiction with it, he’ll be in trouble with the DEA.)

I am certified to prescribe buprenorphine, and have used it to withdraw patients where I deemed it appropriate. But I must admit, unless one is withdrawing from extremely high doses of heroin, oxycontin, or methadone, it’s usually easier to just detox the person and treat their withdrawal symptoms with other, non-opiate drugs like anti-nauseants, anti-diarrheal medication, clonidine, and non-narcotic pain killers. The worst is over in 72 hours.

For 99.9% of opiate addicts out there, withdrawal is not life or health threatening. Uncomfortable as hell, yes. But not dangerous. And I speak from professional and personal experience.

I’m not fond of governments mandating that physicians must prescribe certain drugs for certain situations.

But, opiates are the religion of the masses! Or something like that . . .

US and European practices in this matter differ. Methadone is the normal treatment for maintenance and withdrawal in the UK. This case was won because the people affected were undergoing methadone maintenance or withdrawal in a health facility outside prison before imprisonment. The removal of this treatment has now been equated by the Home Office (responsible for prisons) as equivalent legally to assault- the causing of injury by the commission or omission by the perpertrator, and therefore illegal under the Human Rights Act. When looked at in this way, the case was really a no-brainer and the Home Office has admitted this by deciding to accept the case rather than fighting it in court.

The net result of this will be that detox and maintenance programs will now be available in Prisons. This may also be connected with the fact that since April, English and Welsh prsions have lost their rights to provide health services (of a very poor standard historically) to prisoners, and these services are now provided by the local National Health Service and within the prison. This has removed the role of the Prison Staff from deciding how medical treatment should be carried out. I can see that a maintenance program within prison for addicts will cause the use of illegal narcotics in prison (which is widespread) to be controlled.

It is worth noting as a side issue that the pendulum is swinging back in the UK towards maintenance prescription of injectable diamorphine as a method of controlling the problem of drug use in society. This was standard procedure in the seventies and eighties and the cessation of these programs is blamed in part for the massive increase in heroin addiction in the UK.

The government has not mandated treatment in this case but has stated that there is a right to expect the same treatment within and without prison. No doctor is forced to Rx methadone.

Even the BBC evening news opened with a very misleading headline last night, something to the effect of “prisoners addicted to heroin win compensation over right to drugs in prison”; giving the false impression that the prisoners in question had been given the right to receive heroin.

I understand there is currently some controversy over the effectiveness of methadone, but that’s an issue that should resolve one way or the other for everyone, both in and out of prison. Healthcare should not be withheld from people just because they are in prison.

When I worked in Florida during the summer I had a roommate that was a Heroin addict. You could literally walk in his room and find syringes all over the floor. During the time I stayed there he began going to a Methadone clinic and the treatment seemed to have some very adverse effects. He constantly dozed off while we were working, while he was eating, and he just always seemed out of it and never slept at night for more than an hour or so, then he would suddenly have a burst of energy temporarily about two hours after getting his Methadone fix. Well he got into a car wreck after taking some xanax and went to jail for hit and run. He spent about two weeks in jail. It seemed like going cold turkey was a lot more effective and his health seemed to really go up after he got out. His appetite was greatly improved, he was able to get more sleep.

It seemed like going cold turkey was much more effective and faster than the Methadone.

I’m gonna get on my high horse now and I expect a fair amount of abuse for it.

I don’t take drugs, never have and never will. I’ve never even smoked a “spliff”

So…diggleblop why did you take drugs?
You must have known the dangers of drug taking and you must have known how difficult it would be to kick them.
What were you thinking of to go down that path?. I assume you are a reasonably intelligent person, did you not for just 10 seconds realise how stupid your actions were, how destroying your habit would be to yourself, family and friends.

I’ve known a few junkies and from what I can see these people will lie, steal, cheat, do anything for their next fix even to the extent of stealing goods and cash from close family.

I’m sorry but I have no time at all for anyone who treads such a dangerous path.

Why is this even remotely an appropriate post for this thread?

Agreed, totally inappropriate.

The mods may delete it if they so wish.

Hokey dokey chowder, what’s your attitude to immediate withdrawal of alcohol from new prisoners who are chronic alcoholics? Should their withdrawal symptoms be mitigated or should they suffer?

jjimm I’ll not be drawn into any debates my friend, this is my last posting in this here thread. Sorry and all that.

BTW I do drink so I guess I have taken drugs, oh I also smoke terbakker

How is this different from governments mandating that physicians must not prescribe certain drugs for certain situations?

If you are referring to the title of the OP, I chose the words very carefully. If a prisoner is in treatment for withdrawal when admitted to prison, then in future it will be very dificult to not continue that treatment.

The short version: I was injured while working for TSA as a security screener, I was thrown against a conveyor belt at Dulles Airport and ruptured L4 and L5 of my discs in my back. I am overweight and have heart trouble, so surgery is not an option.

I was given painkillers, a lot of them and for more than a few months. They helped, but in the process I got hooked on them. It’s a damned if you do, damned if you don’t situation. Without them, I am in extreme chronic pain and with them, I feel like an addict. I finally got approved through workers’ comp for physical therapy and have been feeling better ever since. I still have a minor disc bulge that needs to be corrected with surgery.
So does that answer your question? Not all opiate addictions are heroin or street drugs. Some people actually need them for pain.

This ruling only covers those who were already undergoing treatment involving the use of medication prior to being sent to prison.

In reality, it isn’t even a ruling, because this is an out of court settlement, albeit in expectation of losing in court itself.

It doesn’t set precedents, nor is any liabilityaccepted.

Maybe it will provide an impetus for more detox facilities, the way the English Prison Service is organised, its pretty much centred around achieving numbers in boxes rather than actually addressing the problem.

The system of UK prisons inspections, Key Performance Indicators, targets etc is very much like Heisenburgs uncertainty principle.

By making measurements you can change the properties of the quantity being evaluated, such that you cannot be absolutely certain of the facts, this is exactly what happens in the Prison Service.

Standards are set based upon supposedly Key Markers, for example, a Prison will be told to carry out drug testing, and based upon the years number of positive tests, a target will be set to reduce that number for the following year.

There are so many ways to distort this, how about the following - you can ensure that in your first year you make sure you target all known drug users, this ensures you have a high number of positive tests to start with, its much easier to go down from a high number than from a low number.

The following year, you make sure you do not test for drugs on a weekend, this ensures a reduction in positives, because hard drugs will be consumed on a Friday, and these will mostly be out of the system by Monday morning, which is when weekday testing resumes.

You could also target those who you know are clean, which means that your number of positive tests falls, and hey presto, your jail has now achieved its target of ‘reducing drug abuse’.

Many UK prisons have ‘frequent testing’ units, where prisoners will be tested more often, and naturally those who do not take drugs will make up a higher proportion of their population, and magically it makes the jail look good.

Obviously the rest of the jail is rife with drugs, but doesn’t make as many drug tests as the frequent testing units so this does not hurt the numbers so much.

There are so many differant ways that the numbers are manipulated to achieve the so called improvements, wether it is reductions in assaults and bullying, or just completion of offending behaviour courses.

The result is that although numbers are being gathered, the actual effect of doing this in order to meet targets so distorts reality that its very difficult to have a true picture of what is really going on.

In truth, UK jails do not have many true detox units at all, because this involves certain security and isolation facilities, along with the medical support and so many other things that UK few UK jails are equipped to do this work properly.

If you really wanted to carry out true drug rehab and detox, the first thing you would do would be to ensure no physical contact between visitors and prisoners, this would have to take place behind screens.Visitors are how the majority of drugs get into prison.

The rehab population would have to be isolated from other drugs sources, so in effect you would need another prison inside the prison, so that they could not get drugs from other prisoners. You would also need to ensure that prisoners do not have the assets to purchase drugs, by strictly limiting the money they are having sent into prison by relatives, personally I would stop all money coming in but there are other reasons why this is done, few of which I feel are in the prisoners own interest, and everything to do with the interests of the Prison Service.

You would also need to install jamming devices for mobile phones, this is the way many drugs transactions are carried out, cash is sent from one address to another, and upon clearance of funds, the drugs are supplied to the user.(prisoners are not allowed to have moblile phones, but then, they are not allowed many things and still they obtain them)

Unfortunately there is a law that forbids the use of devices that jam electrically transmitted communications.

All goods coming into such a place would have to be searched, and given the amount of material that moves in and out of prison, such as clothing, food and a thousand other things, it would mean a large and specialised search team.

All staff would have to be searched, and drug dogs on duty with their handlers most of the day - most UK prisons do not have their own dog units.

All this is just for starters, you would need to have specialist counsellors, pschologists, seperate employment and training facilities, and upon release from prison there would need to be extensive supervision in the community, unlike the joke that we currently use, you would need to get these individuals into employment (assuming you could actually train them to do something useful. like read and write) the list is almost endless.

The result is that our genuine detox units are way oversubscribed.

We all know what to do about it, the measures are expensive, they are not easy, but the reality is that Joe Public is not going to vote for a political party that promises more spending on criminals unless it involves locking them up forever, Joe Public is not interested in the slightest in rehabilitation, but is rather keen on revenge. I’m not surprised by this, and I understand the reasons for this point of view, its just how it happens to be.

diggleblop I apologise most sincerely if you felt offended by my post, this was not intended, quite stupidly I jumped to the conclusion that your addiction was thru’ self inflicted abuse, I feel really silly now :smack:

Yes I do realise that some people need drugs to combat pain, it’s a lose/lose situation and I feel for those people who need the drugs simply to live life without constant agony.

I hope that your surgery is a success.

I was wondering that too upon reading the thread title, since methadone, while an opioid agonist is not an opiate according to some definitions.

Although technically not setting any legal precedent, any future claims would face an open door. There is no way now that the Prison Service can stop future treatment of people currently on withdrawal programmes when admitted to prison. In future this decision will anyway be taken by NHS employees rather than Prison Staff- a case made well today by Radio 5. Since April, medical services have been under control of the NHS Trust local to the prison and not the Prison Service itself.

But such facilities will have to provided in some manner now, or people will continue to sue either the Prison Service of the NHS Trust.

This shows that a Prison mindset is not compatible with modern healthcare. Rehab and Detox units in the community do not need to resort to above such draconian methods. The regime is simple- if someone wants to withdraw or enter a maintenance programme then they must be willing to do so. This involves their own determination to follow the programme. If they fail to follow the programme with all the support offered, then they will be thrown off the programme. If they test positive for street drugs, they are off the programme and hence lose their rights under the programme to Methadone.

In fact detox under ‘unchallenged’ conditions is virtually worthless in terms of long term behavioural change. It is necessary that there be risks of re-use available that the person is able to learn how to avoid such relapses.

No, all that is required under the law is that equivalent medical services be available within and without the prison service. It does not have to be gold-plated either in or out of prison, just equivalent.

The result is that our genuine detox units are way oversubscribed.

One of the main benefits of the transfer of funding from the Prison Service to the NHS is that these decisions will now be made on Healthcare grounds rather than on Incarceration grounds.