Popping Pills

This blog was written in November, 2014. 

            Drugs solve nothing yet the biggest drug dealer I’ve ever met is the medical unit inside the prison. I’m not talking antibiotics here (though a young man I know is going out this week for an ultra-sound because he may have testicular cancer. This guy was given antibiotics for the past 3 months, “just an infection,” he was told), I’m talking Prozac and dozens of other pills because guys think they’re depressed. They need pills – or they think.

            First, if you don’t get the least bit depressed over this environment, you are crazy. But men in here want meds. And that is the problem. One of the guys I know went back on Prozac this week. “I’m stressed,” he tells me, worried about going home in 11 months. Now, this guy’s time in here was directly tied to alcohol abuse. He knows he has to avoid alcohol – and drugs – when he leaves. Why then, would he turn to Prozac? More importantly, why would the system so freely give him Prozac (with only a quick visit with the “onsite psychology unit” – read non psychologists – and a 5 minute video chat with a state-employed psychiatrist)? I’ll tell you why – because it’s easier medicating guys than dealing with them. And for the guy I know back on Prozac – he thinks numbing his mind (and sleeping 16 hours a day) will help him deal with the guilt and remorse he feels. It won’t.

            Drugs are everywhere in here. I write about it a lot. But, the other truth is, DOC pushes drugs in here. They want you on meds. It gives them control. Is depression real? Yes. Is there a place for Prozac and Zoloft? Sure, but in proper doses under proper medical treatment. That doesn’t happen in prison. Stop pushing pills in here! There are too many zombies behind bars, too many guys getting hooked on too many substances that will cause them problems after release. Then again, maybe that’s what the powers that be want.   

Gary & Thomas

Gary and Thomas moved out of our building – involuntarily. Neither man was in college. Their assignment to 4A was mere happenstance. They both are under eighteen months and were “ready” for the first phases of re-entry. Building 3 is all re-entry, with 4B twelve to eighteen months and introduction to the “pre-cog” community. Overflow from B side is housed in A’s fifteen non-college beds. So Gary and Thomas were moved to 4A. Neither man could read; both men suffer from mental illness and are loaded up with handfuls of skittle colored pills to “regulate” their behavior. And even with the pills, both men went nuts and were “checked in” to the padded suicide cell in 7 building.

            The pill life. In here close to 50% of the men are on something. Don’t get me wrong; medications have their place in modern society. We live in an age where pharmaceuticals cure or limit the effects of diseases and conditions that one hundred years ago would have meant death at an early age. But we have become addicted to drugs without adequately evaluating the consequences of our over-dependence. And that addiction comes with a heavy price.

            Nowhere is the evidence clearer of our over-reliance on prescription meds than inside prison. Pills – meds – are a means of control. It’s far easier for the state to dole out prescription meds than address the underlying causes of many of these men’s problems. And prison – while an isolated lifestyle – is not an island unto itself. The reason the Department of Corrections allows medications to be the primary method of inmate health care is because the same is true in the “real” world. Pills are the answer.

            I have a friend in here, fifty-one, retired Navy. He made a horrible mistake one night and driving drunk crossed into a controlled intersection and killed two people. That was in 2006. To this day, he can’t even mention the accident without tearing up. While he sat in jail, pondering his responsibility for the loss of two innocent lives he heard from his wife that she was divorcing him. “I’m not going to put my life on hold for ten years while you go to prison,” she wrote. He fell into a deep depression. Unable to cope with the guilt over his reckless deed and now reeling from the loss of his wife, my friend actively contemplated suicide. The jail “routed” him to the facility psychiatrist. After a visit lasting less than ten minutes the doctor called in an 80 mg prescription (twice daily) of Prozac. Three weeks ago he came to the realization that the meds (now one 30 mg dose a day) weren’t doing what he needed.

            What he needed was to come to grips with what he did. What he needed was to own up, admit his responsibility and move forward. The meds kept him from that. About a year ago, this decent man, a wayward Catholic by his own admission, returned to the church. Monthly he would go to confession when the priest would come. The confessions, the readings, the self-examination allowed my friend to begin to heal. It was this healing that led to him stopping the Prozac and sleeping for fourteen hours every day. Now, he exercises, and prays, and takes college classes, and lives.

            A personal confession. I find myself in jail. The first night they put me on suicide watch – standard procedure anytime someone from “my side of the tracks” gets locked up. The next morning, a counselor asked me, “you’re aren’t going to hurt yourself, are you? When I said “no,” I was moved to a low custody pod and forty other men. I walked in the pod dayroom and felt like I stepped into the psych ward of “One Flew Over the Cuckoo’s Nest.” I was witness to a range and array of characters and behaviors I didn’t know existed. I was a mess – on the inside – yet no one knew. I carried myself with head high, joking, out-going; all the while I planned to end my embarrassment, pain, and self-loathing. I didn’t. Why I didn’t is between God and me, but my “Damascus” moment didn’t make me brave or responsible or giving. I was still a mess, just a mess who decided to see life through.

            A week after my arrival, I met the jail psychiatrist, an out-going, funny Filipino man who took an instant liking to me. “Are you depressed?” Of course I was – who wouldn’t be? My whole life was destroyed – marriage, wealth, prestige – all was gone. He then read the articles about me from the paper and in less than fifteen minutes came up with a “proposed” diagnosis. “You’re brilliant, personable, successful. You must suffer from mania. We’ll call it a slight disorder and see where that leads.” Mania – that explains my reckless behavior I thought. I’m not responsible; I’m ill. He then prescribed me 10 mg of trazadone (an anti-depressant) nightly to “help” me sleep.

            I clutched onto his diagnosis and treatment. I exaggerated in letters my conversations with the good doctor – anything to get sympathy. And, after only two days of pills, I started flushing the trazadone. I didn’t need it. What I needed to get sleep was to admit to myself and my God what a wreck I’d made of my life. And, I needed to “man up” and do the right thing regardless of the outcome. It was during those very dark, very difficult days that I agreed to plead guilty to all charges without a plea agreement on my sentence and to ensure my family was provided for, I soon discovered self-respect helps you sleep better than a bottle or a pill ever will. Like Tom Cruise’s character in “The Last Samurai,” honor and self-respect may be the best medicine for a broken soul.

            Pills; everywhere pills. The other night there were 38 men getting meds from our side, out of 66. Many of the men getting Zoloft, and Xanax, and Prozac, are in here on drug charges. Their treatment plans require alcohol and drug programs; their mental health plan requires high doses of meds. Even the “real” mentally ill – the schizophrenics – they are over-medicated to the point of being non-functioning. Gary and Thomas would sleep upwards of twenty hours per day. Personal hygiene – cleanliness – is forgotten; all there is is a vacant stare.

            It isn’t healthy and it isn’t right. There is no actual psychiatric treatment, just monthly videoconference “how are yous.” Side effects from most of the anti-depression and anti-psychotics require blood work quarterly to verify the pills aren’t destroying the user’s liver. Men go home with new addictions, new crutches.

            What’s the answer? Let’s face it, as USA Today pointed out in a cover story this week; mental health is the expendable item in most state budgets. It’s the dirty little secret no one wants to discuss until there’s a Newtown, or a Columbine, or PTSD Marine who goes off and kills women and children in an Afghan village. We ignore the problem and then “lock ‘em up.” Worse, we think a pill can solve the problem.

            Pills aren’t the answer. Somebody needs to do better for Gary and Thomas. By the way, what’s in your medicine cabinet?

Mental Health

Much was made of the tragic, self-inflicted gunshot death, of Sen. Creigh Deed’s son over Thanksgiving. It once again focused attention on Virginia’s broken mental system. I have written regularly about the large number of over-medicated inmates and their “thorazine” shuffle, how prison psychiatrists write prescriptions for “cocktails” of multiple anti-psychotic meds with little or no actual treatment being offered.

      And it is even worse. Forget the long-term health concerns from poorly managed anti-psychotics; there is the lack of coherent mental health care on site that is equally appalling.

      The prison employs three women in a “psychology” office. Problem is, none are psychologists. All three have BAs in psychology but nothing further. They serve as “gatekeepers” – they make “treatment” recommendations – for the D.O.C. psychiatrist who literally is a “Doc-in-the-box.” Medicated inmates speak to the psychiatrist via videoconference for less than 5 minutes every 90 days. There is no other medical treatment except blood work (these psychotropic drugs can cause liver damage).

            The “psychologists” are quick to offer diagnosis and place an inmate in a category: bi-polar disorder; schizophrenia; depression; there is a “top ten” list and men are neatly packaged into them. But, without meaningful one-on-one care all that is done is place the men in a drugged stupor. And these labels – so easy to attach – become self-fulfilling. These labeled men then tell you they can’t “help” their behavior. They have a “disorder.” And they use the disorder as a crutch; and they believe they are entitled to disability and release from prison without addressing why they did what they did. They are lied to repeatedly about their condition and then over-medicated and under treated. They go home and fall back into the same self-destructive lifestyle. And they return.

            That isn’t mental health. Many men here have significant psychological issues. However, the answer isn’t always high doses of mind-numbing chemicals and catch all diagnoses chosen from the newest DSM like one would order off a menu. Legitimate mental health education requires one-on-one treatment and regular assessment and control of prescription medication. That doesn’t happen in here.

            Like most things involving the Virginia Department of Corrections, mental health treatment exists only as words not as a real program. The cost – to provide actual in-patient treatment – would be staggering. Instead, the men are treated like cattle at a slaughterhouse. Each night forty to forty-five of the seventy-two men I reside with line up for pill call. And they have their pills placed in small Dixie cups – Seroquel, Prozac, trazadone, thorazine, the list (and the pill colors) are endless.

            They take their pills, numb their minds, and stagger back to their bunks. Some day they will be released; but what are the ramifications for DOC’s mental health failure? What indeed.

The Senator's Son

A lot of attention was directed toward State Senator Creigh Deeds as Virginia’s new Governor – Terry McAuliffe – was sworn in. In less than one week, the outgoing Governor recognized Senator Deeds return to work during his farewell “State of the Commonwealth” address. Face it; Senator Deeds presents a compelling story. It is a story, unfortunately, that is widely ignored and swept under the proverbial rug except when violence erupts. Then – and only then – do we ask “why?” Why indeed.

            As everyone knows, shortly after Thanksgiving week a 911 call was placed by a neighbor of Senator Deeds. The Senator had been discovered staggered and bleeding as he walked along a rural roadway in Bath County. Deeds had been stabbed numerous times. Police went to the Senator’s house and during a guns-drawn search, found the body of Deed’s son, dead from a self-inflicted gunshot wound.

            Within a day the public learned that the Deeds’ son had suffered from serious mental illness. Interestingly, it has not been disclosed what this actual diagnosis was. A bright, quiet kid, his mental disorder led him to leave William and Mary College and – just days before his suicide – a failed attempt by his father (Senator Deeds) to have the young man hospitalized. For another few weeks (just like after the VA Tech massacre) Virginia’s mental health apparatus was on full display. The picture was not good.

            And now, with Senator Deeds healing from his physical wounds while grieving the death of his beloved son, the politicians gather again in Richmond to kick off yet another session of the General Assembly, and they say, “Something must be done about mental health.” Please, give me a break.

            His name is Gary. Of course, it could be Thomas or Tyrone or a dozen other names. Gary is thirty-five and suffers from schizophrenia. Each day, both morning and evening, Gary takes a combination of psychotropic medications. The pills dull his senses to the point that he sleeps upwards of twenty hours a day. It’s the only way DOC has found to turn off the voices in Gary’s head. That’s right; Gary hears voices, multiple voices. The pills work most times. But, there are other times, like last week …

            So Gary’s up three days straight. Even doped up with enough crap to stun a bull moose, he’s up twenty-four straight hours for three days. He’s fidgety. “What is it?” I ask, when a friend of Gary’s asks me to write up an emergency grievance to get him to medical. “It’s the voices,” the guy tells me. “They’re talking non-stop and telling him all kinds of crazy shit.” So I file the emergency grievance and I put in it, “psychotic breakdown,” words Medical knows Gary doesn’t know, and an hour later he’s called to medical. I see him a short while after that. “How’d it go?” I ask. “Ok. I’ll see the Psych tomorrow on video conference and he’ll adjust my pills.”

            That’s right; the psychiatrist isn’t actually on site. He handles multiple prisons via “video conference.” Five minutes on camera and a new script is written. More pills prescribed. It’s economics. You’ve got over one-third of the men here on psychotropic meds. That’s the extent of DOC’s psych treatments unless you’re unlucky enough to find yourself sent to Marion – that’s the state prison for the criminally insane.

            How bad do you have to be to end up in Marion? Try this: I’m at the receiving unit, also known as “hell,” and there’s a nineteen year old kid so wacked out that every night he’d scream “help me Jesus, they’re killing me!” He’d yell like that for hours until 4:00 a.m. when he would shout like a rooster “cock-a-doodle-doo.” And, paper, bars of soap, and profanity would be unleashed against the front of his cell. That young kid was shipped to Buckingham a level 3 prison. He was crazy, not criminally insane.

            Yeah, mental health should be a priority for the state. Almost half the Virginia DOC inmate population suffers from some mental disorder or illness. Here’s the irony: Tens of thousands of Virginians suffer from a mental disease or disorder and the state uses the criminal justice system to control them. Schizophrenic? Hear voices? That’s no excuse. You break the law, you go to prison. Then, all the prisons do for your mental condition is load you up with drugs. You need mental health services in the Commonwealth? Go to jail. At least you’ll get meds.

            I’m sick of politicians and private citizens wringing their hands every time a young Mister Deeds appears on the scene. Collectively, we don’t give a shit about mental health. It’s only after the poor, sick bastard acts out that we talk about it. You want to see how much Virginia cares about mental health? Come inside a prison during “pill call” and watch the hundreds of zombies stand in line for their hit of Prozac, or Thorazine, or Seroquel, or all three.

            There’s another young Mr. Deeds out there and Virginia’s only solution right now is to let him act out then watch him kill himself or send him to prison. That’s harsh, and vulgar, and way too accurate.