The FDA’s Recent Actions Against Opioid Manufacturers

What actions has the FDA taken to stop opioid addiction where if often starts: with prescription pain medicine? In June 2017, the FDA requested for the first time that a prescription opioid be taken off the market. They said they were concerned with its benefits compared to its potential risks. Said FDA Commissioner Scott Gottlieb, M.D. “We will continue to take regulatory steps when we see situations where an opioid product’s risks outweigh its benefits, not only for its intended patient population but also in regard to its potential for misuse and abuse.” The drug, Opana ER, was being abused by addicts in forms it was never intended to be used in. Also, injecting it was causing other connected health problems, such as HIV transmission and blood diseases. In the realm of correctional medical care, the signal that the FDA is taking the opioid crisis more seriously means a lot. So many inmates today are addicted to opiates or opioids. They are difficult to care for, and while our staff always do their best, they can be hamstrung often by those who see addiction as a criminal rather than medical... read more

A History of Prison Ships

For a period of time in the 18th and 19th centuries, it was common for old, decommissioned sea vessels to serve as floating prisons. Known as prison ships or prison hulks (a hulk being a term for a ship which is no longer seagoing), these were considered a good use for vessels whose days as working boats were over. The British and their colonies and possessions were the primary user of the prison ship concept. They were most famously used in America during the Revolutionary War. More than 11,000 Colonial POWs died in British prison ships during the Revolutionary War. Conditions were notoriously awful on these ships. Overcrowding and disease were rampant. In Australia, a huge influx of a criminal element in the 1850s resulted in overcrowding in terrestrial prisons, thus leading to the use of prison hulks. Today, while far fewer in number, the floating prison is still in use. In fact, the largest floating prison left in the world is located in New York, the Vernon C. Bain Correctional Center. Although it was never a seagoing vessel, until 2002 the US Coast Guard did require the Center to have maritime-trained personnel on board, including a... read more

A Statement From CMC and CBH Medical Regarding Recent Events in Schenectady County, New York

To our clients, employees, and other interested parties: As has been reported in the media, Correctional Medical Care has been named in a complaint filed by attorney E. Robert Keach on behalf of his client Michael Revels. CMC has received  a copy of this complaint, which makes numerous allegations that are knowingly false. Unfortunately, CMC is precluded by law from publicly responding to Mr. Keach’s false statements concerning the care of Mr. Revels or any other patient. Mr. Keach’s complaint simply has no basis, as will be proven in Court.  For example, CMC does not and never has owned CBH Medical, as Mr. Keach alleges, and CMC does not provide medical care in the state of New York. Rather, CMC is an administrator of a contract between Schenectady County and the independent medical provider, CBH Medical, a fact of which Mr. Keach has regularly been informed. Moreover, CBH Medical and its staff do not and never have based any medical decision on profit margin and do not withhold medical care to enhance profit. There is absolutely no motive for CBH Medical to withhold hospital care for incarcerated patients as Mr. Keach falsely claims. Also CBH Medical does not bear the cost of any such hospitalization, which generally is paid by Medicaid. CBH Medical provides high-quality medical care to the jail population of Schenectady County and other counties including Albany County and Rensselaer County. On a daily basis it provides needed medical care and treatment to thousands of incarcerated individuals. This population includes many individuals with a long history of diverse and often serious medical issues, many of whom have had... read more

Pennsylvania Closing Two State Prisons

Governor Tom Wolf says the state will close two prisons to save money. The state prison inmate population had dropped considerably in recent years, which is prompting the cost-cutting move. Five state prisons are on the list of possible cuts. But this is not sitting well in communities that are dependent on correctional facilities for jobs. In Pennsylvania, as in many states, many rural communities depend on these types of prisons as crucial employers. In some counties, the correctional facilities employ so many locals that other businesses, such as local retail, dining, and other business, will suffer second-hand effects from closings. In order to make up for the lost beds, prisons will be running over capacity, which could make correction officers and medical personnel’s already difficult jobs more stressful.  The job of rehabilitating prisoners, already so difficult, will get even tougher. There is also the chance that due to these overcrowded conditions, overtime will go up, partially negating any cost savings the commonwealth was hoping for. Members of both political parties from all five counties are already making the case to the governor that their county should not be the one to lose out in the... read more

Caring for the Elderly After Prison

What happens to an elderly inmate when they are released? Would it be beneficial to release more elderly inmates back into the community? The American population in general is becoming older, and correctional facilities are no exception to this. These inmates can place an exception burden on facilities and governments responsible for their care. Conditions for the elderly and infirm are often extra challenging when they are kept in prison. Due to limited space, resources, and equipment, they are not easily made comfortable. Most prisons were not made with accommodating those who have difficult walking in mind. It is estimated that older prisoners are two to three times more expensive to care for than younger ones. And while incarcerated, inmates are not eligible for Medicaid or Medicare for treatment inside the facility. Correctional health providers know how costly in time and dollars it can be to take care of elderly inmates. Releasing them to live out their days in the community provides a better general outcome. Increased usage of compassionate releases can help realize this. No matter what, it is an issue that will need more and more attention as populations... read more

The Dangerous World of Prison Weaponry

As any medical provider in a correctional environment can attest to, there are unfortunate lengths inmates will go to craft weapons they can use against other inmates, officers, or even health care staff. Annually, thousands of correctional workers are injured by these weapons. Inmates may claim that the weapons are only for defensive purposes, but obviously, that’s often not the case and it’s a circular argument anyway, as the weapons in that case create the need for more weapons. And obviously due to the nature of the mindsets of the incarcerated, they may be more willing to use these weapons than most people. Medical equipment itself has been fashioned into weaponry, which means medical staff must be vigilant in ensuring inmates do not access items. And there is also the risk of so called “weapons of opportunity,” objects within reach that can be used to cause harm. Reducing potential for harm from both inmate-on-inmate and inmate-on-staff attacks makes the medical department’s job more... read more

Solitary Confinement and the Mentally Ill

According to several studies, the mentally ill suffer more from solitary confinement than the non-mentally ill prisoner. Also, when compared to the rest of the inmate population, the mentally ill are more likely to end up in solitary confinement, thus creating the potential for a cyclical effect. Research has found that diagnosed mentally ill inmates have higher suicide rates and rates of self-harm when they are exposed to the conditions of solitary confinement. Also there is the complication of delivering care to a patient who is being kept in isolation via confinement. It is simply more difficult for a care giver to access the person on an effective level. It should be noted, however, there is not a consensus on the matter. Other researchers claim that the studies were poorly constructed and performed, and more study is needed before reaching a conclusion on the effects of solitary confinement on the mentally ill in correctional... read more

Confinement Shock and Suicides Behind Bars

A lot goes into preserving one’s mental health. If someone is struggling with mental illness, whether it’s depression, anxiety, bipolar disorder, dissociative identity disorder or any of the number of debilitating mental health disorders that plague society, the main goal of treatment is to keep them safe and help them cope with the issues that are weighing them down. Without adequate treatment, any number of outcomes are possible, almost all of which are absolutely devastating. Suicide, of course, is an often-avoidable outcome of a horrible mental illness that goes untreated or mistreated for too long. With the walls of prisons, suicide is far too common. According to NPR, about 1,000 people die in US jails each year. Roughly one-third–or a little over 300–are suicides. So why are suicides within prison walls so common? Part of it is easy to understand–inmates of prisons have been handed down sentences that range from a few months to multiple life-sentences. These are people who have potentially given up the opportunity at ever having a life of freedom again. Often, they’ve committed crimes that sully their reputations both inside and outside of prisons. If these people are also suffering from untreated or undiagnosed depression, sometimes taking their lives seems like the only way out. Unfortunately, prison and jail inmates sometimes do not receive adequate treatment for their mental and emotional needs and wind up hurting others or themselves. This sense of helplessness after a conviction and sentencing can mentally drain an inmate. Interestingly, though. after conviction, suicide rates actually drop. While about 46 out of every 100,000 jail inmates wind up taking their own... read more

Mental Health Treatment Within Prison

There is no “standard” or “normalized” or “one-size fits all” treatment for those suffering from mental illness. There are medications, there are psychiatric evaluations, psychiatrists, psychologists, therapists, light treatments, exercise, occupational therapy–the list goes on almost endlessly. When someone is diagnosed with a mental illness, a mixed-bag approach can be taken; not every treatment works for every individual–they are tailored approaches to treating debilitating illnesses. When you’re outside of prison, this approach is more easily malleable, more easily flexed to fit the specific needs of the individual. Whether it’s depression, anxiety, Schizophrenia, bipolar disorder or any number of the wealth of mental health disorders that are prevalent in our society today. The treatments are flexible and there is room for adjustments when necessary–you can see a therapist once a month, once a week or once a day. Inside of prison, treating mental illness becomes more difficult. Within prisons, mental illness is already an enormous issues–a good percent of the prison population suffers from mental illness which can, in certain cases, go untreated. Living with a mental health condition within the walls of a prison can be difficult, even overwhelmingly so. This is due in part to the fact that the closure of mental health facilities around the country have increased the prevalence of the mentally ill in prison. Often, if they cannot get treatment at a psychiatric hospital, prison is the only option left. And the treatment options in prison become significantly more difficult. Severe mental illness is present in about 25% of the correctional population in the United States, including individuals in prisons, in jails, and on probation.... read more