Prepared for NAPAS by

Center for Public Representation

March 2000

    It depends on the type of medication and the nature of the prisoner's illness. There is noquestion that an inmate with a major mental illness, such as schizophrenia, bipolar disorder, ormajor depression has a right to medication (if he wants it), since the Federal Constitution mandatesthat correctional officials provide appropriate treatment to any inmate with a "serious" medicalneed, and medication is an integral part of treatment for these conditions. Smith v. Jenkins, 919F.2d 90 (8th Cir. 1990); Waldrop v. Evans, 871 F.2d 1030 (11th Cir. 1989). However, not everymental disorder is sufficiently "serious" to qualify for constitutional protection, even if a doctorin the community has already prescribed medication for it. See Doty v. County of Lassen, 37 F.3d540 (9th Cir. 1994) (nausea, shakes, headache, sleeplessness, and depressed appetite insufficiently"serious" to mandate medication). But see Steele v. Shah, 87 F.3d 1266 (11th Cir. 1996)("insomnia, anxiety, and various bodily pains" and "feelings of helplessness" entitled inmate tomedication).

    Prisoners are not, however, entitled to their choice of medication, or even to themedication that is most likely to help their condition. So long as a qualified prison doctorperforms a thorough evaluation of the inmate, and reviews his medical history, courts areunwilling to interfere with the professional judgement of the prison medical staff about whichmedications, if any, are appropriate. Vaughan v. Lacey, 49 F.3d 1344 (8th Cir. 1995). Althoughmost jails and prisons have policies designed to ensure that there is no interruption in themedication of a newly admitted inmate, many facilities are reluctant to provide inmates with certain drugs, such as the newer antipsychotics or the benzodiazepam tranquilizers, because of costor security considerations. See Wolfel v. Ferguson, 689 F.Supp. 756 (S.D. Ohio 1987); Mathisv. Cotton, 1997 WL 457514 (N.D. Tex. 1997). Further, the procedures used to determine whatmedications are appropriate ofter result in delays before the inmate receives treatment. See Mahanv. Plymouth County House of Corrections, 64 F.3d 14 (1st Cir. 1995). Many institutions will alsosubstitute cheaper medications, which are on their formulary, for the medicine that was prescribedby the treating physician in the community. These kinds of practices are not generally unlawful. See Bridges v. Jennings, 1998 WL 223276 (10th Cir. 1998)(upholding refusal to continueprescribing Xanax to addicted inmate); Lewis v. Plummer, 1997 WL 168530 (N.D. Calif.1997)(prisoner not entitled to Valium which he was taking prior to his incarceration); Lawthornv. Duckworth, 736 F.Supp. 1501 (N.D. Ind. 1987)(prison policy of limiting use of Valiumbecause its value outweighed by the risk of offenders hoarding and selling it in the prison). However, if a prison terminates medication, care must be taken to ensure that the dose is graduallyreduced when this is medically appropriate. See Mathis, supra (inmate experienced seizure whenValium abruptly terminated).

Attached Files:
crim_just_meds_in_prisons.wpd 40 k