ARM-ME BLOG

Thankfully this woman is suing the jail!

Suit: Pregnant woman denied necessary medication, put in solitary confinement, while in Montana jail on traffic offenses

Bethany Cajune is a young woman in western Montana who sought treatment from the Confederated Salish and Kootenai Tribal Health Clinic Behavioral Health Program for an addiction to the painkillers she was given following a surgery. She made good progress there. As part of that recovery, Cajune – who was five months’ pregnant – sought to complete an outstanding sentence at the Lake County Jail. That’s when things began to go downhill. The Missoulian’s Vince Devlin tells her story here:

POLSON – A Ronan woman who says she was repeatedly denied a prescribed medication while pregnant and serving time in the Lake County Detention Facility for traffic violations has sued the county, Sheriff Lucky Larson, chief detention officer Luke Mathias and Dr. Stephen Irwin, the jail’s medical doctor.

The American Civil Liberties Union of Montana announced the lawsuit in a news release issued Thursday, shortly after the suit was filed in Missoula District Court.

It says that over the course of nine days in jail last spring, Bethany Cajune, 25, experienced constant vomiting, diarrhea, rapid weight loss, dehydration and other symptoms, all “extremely dangerous” to her fetus.

Rather than receiving the necessary medical care, it says, she was instead placed in solitary confinement.

Jennifer Giuttari, staff attorney for ACLU of Montana, told the Missoulian Thursday that Cajune had developed an addiction to painkillers after undergoing two to three surgeries to remove a cyst from her tailbone. She was nearing a year of successful medical treatment for the opioid addiction, and was four to five months pregnant, when she reported to the Lake County Detention Facility to complete a 24-day sentence as a habitual traffic offender.

The lawsuit says Cajune’s counselor, Kathy Ross, spoke to Mathias eight days before Cajune was incarcerated and informed him that to avoid the serious harms withdrawal could trigger in Cajune and to her fetus, Cajune needed to continue receiving Suboxone, a medication that suppresses withdrawal symptoms, while in jail.

After repeated warnings to Irwin and his staff from the doctor who had prescribed the Suboxone – he also faxed letters to Larson about it – that withholding the medication could lead to the death of the fetus, the lawsuit says it took the intervention of a public defender to secure Cajune’s release from jail so she could go back on the Suboxone and receive medical care.

“Punishment is the deprivation of liberty, not unusual and cruel suffering,” Giuttari said Thursday. “Being forced to undergo abrupt withdrawal symptoms, and having to fear for the life of your baby, is not the punishment we’re supposed to hand out for traffic violations.”

The lawsuit says Lake County and its jail staff denied Cajune rights guaranteed her under the Eighth and 14th amendments to the U.S. Constitution, as well as rights guaranteed under Montana’s Constitution.

Cajune v. Lake County seeks unspecified damages.

Irwin was not in his office Thursday, and a number listed for his residence was not answered. Larson said he had not seen the lawsuit, and could not comment.

“Apparently, filing a press release is far more important than informing a defendant about a lawsuit,” Lake County Attorney Mitch Young said. “We haven’t been served, and obviously, I can’t comment on anything I haven’t had a chance to look at.”

***

The lawsuit is the first complaint filed through ACLU of Montana’s new Montana Prison Project, which Giuttari heads, and which seeks to ensure humane treatment of Montana’s jail and prison inmates, including that they be provided with necessary medical and mental health care.

It’s also a part of ACLU’s national Reproductive Freedom Project. The ACLU produced a video about the case that was posted Wednesday on the Internet.

In it, Cajune says she worried that, denied the Suboxone, her fetus wasn’t getting the vitamins and nutrients it needed as she got sicker and sicker.

“I was scared I was going to lose my baby,” she says, adding that at one point she fainted.

“I felt so drained, and so weak from being dehydrated,” Cajune says.

The lawsuit says that, after repeated attempts by Cajune and her treating physician to have the medication made available to her, Cajune submitted an inmate grievance four days into her sentence asking to speak to a judge about her concerns.

On that day or the next, the lawsuit alleges, Cajune was placed in solitary confinement, in a cell with “no windows, a dirty toilet, a sink, a mattress on a cement floor, and a bright light Ms. Cajune could not turn off at any time.”

“The jail had absolutely no basis, in law, in medicine, in humanity, in how you treat a human being, to put her through this,” Diana Kasdan of the Reproductive Freedom Project says in the video.

Asked what sort of traffic violations result in a 24-day jail sentence, Giuttari said Cajune had pleaded guilty to being a habitual traffic offender. They were mostly citations for speeding and driving without a license, Giutarri said, and that “nothing major” had jumped out at her, including any DUIs.

“But what I want to get across is, regardless of what the offense was, everyone deserves constitutional care, regardless of the crime,” Giuttari said.

***

Cajune pleaded guilty to the traffic charges in 2008, and began her sentence while pregnant with her fifth child. She served five days before experiencing early labor symptoms, and was released.

At some point after that child was born, Cajune began making arrangements to finish the remaining 19 days of her sentence. The lawsuit says she called the jail several times to see if a bed was available.

The lawsuit says Ross spoke to Mathias about Cajune’s need to continue on Suboxone on March 10. On March 18, it says, Cajune self-reported to the jail with supplies of two medications she was on – the Suboxone, as well as Promethazine, which treats pregnancy-related nausea.

“Once in her cell on March 18, 2009, Plaintiff requested her medications, but jail staff refused her treatment,” the lawsuit alleges. “They informed her she needed to speak with a doctor before receiving any treatment.”

The next day, the document says, Cajune was given the Promethazine but denied the Suboxone.

On March 20, Cajune submitted a written medical complaint saying she was already feeling sick and would get worse without the Suboxone. The same day, the lawsuit says, Cajune’s doctor, Kenneth Cairns, called Irwin’s office twice. Both times he was only able to speak to Irwin’s nurse, but stressed to the nurse that without the Suboxone there was a substantial risk of both physical and emotional harm to Cajune, and that the health of the fetus was at risk.

Cairns followed up the phone calls with letters faxed to both Larson and Irwin, the lawsuit says.

“He … explicitly warned Defendants that the longer they withheld Ms. Cajune’s Suboxone, the greater the risk of causing permanent harm to the fetus, or even fetal death,” the lawsuit says.

On or about March 20, Irwin did see Cajune, the lawsuit says, but “did not ask her any questions about her condition, or provide a physical exam. He simply told her she could not have her Suboxone.”

Then came Cajune’s written grievance, and her being moved to solitary confinement.

***

Cajune was referred to the jail psychiatrist, the lawsuit says.

“She told the psychiatrist that she was suffering anxiety and continual waves of panic attacks,” according to the document, “and that she needed to go to a hospital.”

It alleges the psychiatrist did not prescribe any medical treatment to address her withdrawal symptoms and never visited her again.

On March 23, the lawsuit states, Cairns again called Irwin and this time spoke with him directly.

“He again explained to Dr. Irwin the medical necessity of continuing Ms. Cajune’s Suboxone prescription and that forced withdrawal was contraindicated (inadvisable) during pregnancy,” the lawsuit says. “Dr. Irwin was unwilling to consider this information and insisted he would continue to withhold Ms. Cajune’s Suboxone medication.”

The lawsuit alleges that Irwin saw Cajune again that day. “Despite having been informed multiple times by Dr. Cairns of the substantial health risks to Ms. Cajune and her fetus, and despite Ms. Cajune’s obvious pain, suffering and signs of withdrawal,” Irwin again refused Cajune the Suboxone.

Cairns visited Cajune at the jail on March 25, and said she “appeared visibly sick and underweight, and visibly suffering from the effects of withdrawal, including muscular pain, nausea, vomiting, diarrhea, dehydration and anxiety – all extremely dangerous during pregnancy.”

On March 26, Cairns again phoned Irwin to express concerns that Cajune’s condition could lead to a miscarriage, and faxed another letter to Larson indicating likewise. Cajune, her wrists and legs shackled, was taken to St. Joseph Hospital in Polson that day for an ultrasound, which dated her pregnancy at 16 weeks and five days, and showed her amniotic fluid measured in the lower limits of the normal range.

The next day the public defender filed his motion, and that evening the Lake County Justice Court ordered Cajune’s release because of medical complications.

On the video, Kasdan says when a pregnant woman is incarcerated, “she of course has the right to continue that pregnancy, and of course has the right to the medical care she needs to have a safe pregnancy.”

“You kind of feel like you’re being labeled, you’re an awful mother for taking this medication,” Cajune says on the video. “That’s kind of what they made me feel like. So then you feel worse about it, on top of being sick.”

Cajune gave birth to the baby, a girl, earlier this fall. The baby is shown in the video. The lawsuit does not mention any issues with the baby’s health.

Reporter Vince Devlin can be reached at (406) 319-2117 or at vdevlin@missoulian.com.

Tags: American Civil Liberties Union, buffalo post, Confederated Salish and Kootenai Tribal Health Behavioral Clinic, Lake County Jail, Native American news

Awesome story on how the media can contribute to epidemics of drug abuse and death!

Opioid-related news media reports and poisoning mortality, 1999 – 2005, United States.

Researchers from four prestigious universities have reported a very high level of correlation
between opiod drug deaths and news reporting of opiod abuse or misuse. There were 24,272 articles and 30,916 deaths involving prescription opioids during the seven-year study period. The study was published November 18, 2009 at   http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0007758

The study makes no claim that media caused these deaths but does cite a repetitive pattern that covers more than fifty years.

This chart and explanation excerpted from the paper “Breaking the News or Fueling the
Epidemic? Temporal Association between News Media Report Volume and Opioid-Related
Mortality” explains the results.

“Monthly print news media volume mentioning short-acting prescription opioid substances closely tracked closely with poisoning mortality due to those medications. Print news media articles consistently preceded mortality by a few months. Month and year of publication and headlines were extracted for any article whose body text contained the generic or branded name of short-acting opioid substances available for outpatient use in the United States during the study period: buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, propoxyphene, oxycodone, and tramadol. Morphine was excluded because a preliminary review indicated articles mentioning morphine almost exclusively described pain management (without abuse) or arts reviews. Poisoning deaths were identified using a combination of International Classification of Disease 10th Edition (ICD-10) codes, see text, to identify deaths involving short-acting opioid substances. Data on methadone are not
presented due to difficulties in distinguishing deaths from its two indications (addiction, pain)
using ICD-10 codes, however inclusion of methadone did not significantly alter results (data not shown). Time series were smoothed using 5-month moving averages.”

Citation: Dasgupta N, Mandl KD, Brownstein JS (2009) Breaking the News or Fueling the
Epidemic? Temporal Association between News Media Report Volume and Opioid-Related
Mortality. PLoS ONE 4(11): e7758. doi:10.1371/journal.pone.0007758

Editor: Wayne D. Hall, University of Queensland, Australia

Nabarun Dasgupta1, Kenneth D. Mandl2,3,4, John S. Brownstein2,3,4*

1 Department of Epidemiology, Gillings School of Global Public Health, University of North
Carolina, Chapel Hill, North Carolina, Unites States of America, 2 Children’s Hospital
Informatics Program at HarvardûMassachusetts Institute of Technology, Division of Health
Sciences and Technology, Boston, Massachusetts, United States of America, 3 Division of
Emergency Medicine, Children’s Hospital Boston, Boston, Massachusetts, United States of
America, 4 Department of Pediatrics, Harvard Medical School, Boston,
Massachusetts, United States of America

Paul Goode was a narcotics investigator in Birmingham, Alabama. Mr. Goode also was involved in UNDO and the DEA. Officer Goode’s duties included giving lectures about the harm drugs do to schools, churches, and other groups. Officer Goode claims he regrets these lectures because he feels the lectures created much more interest in experimentation with drugs than creating a fear of drugs. Mr. Goode is a personal friend and is now retired. The personal experience of a police officer over more than twenty years while considered anecdotal also supports the research conclusions.

Many teachers and psychologists presently write that the most influential people in teenagers lives are their friends. This fact belies the contention of media influence.

In the “War on Drugs” as with every other human endeavor, we appear to always do the wrong thing first. Then we clean up our mess.

The researchers conclude that more prudence should be exercised by the media in reporting “drug articles”. They even suggest some precedent for media control. This would be a violation of “Freedom of the Press”. A self regulation by the media is also suggested but that is concluded to be less than possible as news writers and news readers are more and more sensationalists.

Drug addiction can happen to ANYONE!!

http://www.baltimoresun.com/news/maryland/baltimore-city/bal-md.overdose01oct01,0,6643662.story

By Peter Hermann

October 1, 2009 – Marianne Woessner is a North Carolina  nurse and midwife who sees drug addicts with good jobs and from families every day. They occupy a hidden world that belies the stereotype of rail-thin junkies stumbling from one street corner to the next in search of a fix.

Woessner was the mother of one such drug addict. She made the discovery Sunday night, when a Baltimore police officer called to tell her that her daughter, Carrie Elizabeth John, died that evening after apparently injecting herself with buprenorphine while trying to get high with her boyfriend. Clinton Blaine McCracken, in their rented rowhouse near downtown.

The couple was postdoctoral fellows at the University of Maryland School of Medicine, working in labs on the same floor, studying the effects of drug addiction even as, police said, they grew marijuana inside their home and used narcotics purchased over the Internet from a Philippine pharmacy that shipped pills hidden in stuffed animals.

“These are two brilliant people who made a stupid error in judgment,” Woessner said in a telephone interview Wednesday, as she prepared to bury her 29-year-old daughter in the town where she grew up. Woessner said she doesn’t think McCracken either injected her daughter or forced her to do drugs.

“He loved her and she loved him,” she said. “I know this. They’re humans, just like all of us. We all have our faults. Just because drugs is what they studied doesn’t mean anything. Addiction is addiction, no matter what we do, what race we are, what occupation we have.”

Baltimore police have charged McCracken, 32, with several drug violations, and a department spokesman said federal authorities have expressed interest in pursuing the case. McCracken is free on bail and declined to comment when reached at his home on Wednesday.

McCracken told police, according to court documents, that he and John “thought they could control the morphine and buprenorphine” and that he thought marijuana should be legalized.

Dr. Donald Jasinski, chief of the center for chemical dependency at John Hopkins Bayview Center, said it should come as no shock to see doctors or other medical professionals addicted to drugs, especially those who study narcotics and are around the chemicals daily.

“Anybody who handles drugs think they know how to control it,” he said. “Perhaps the risk group for opiate dependency is doctors.”

Buprenorphine is commonly used to ease heroin addicts off the drug, and is prevalent in Baltimore and other cities as an alternative to methadone. A 2007 Baltimore Sun series described the growing use of “bupe” but noted that it too can be addictive and, while helping some addicts, could create another group of drug dependents.

Jasinski said doctors “who you think would know better” sometimes like to experiment like everyone else . “How many people try to quit smoking and know that it’s bad for them and want to quit but can’t”? he said.

Woessner drove from High Point, N.C., to Baltimore early Monday and spent Tuesday talking to her daughter’s friends and co-workers. She toured the place where John worked and gathered her personal belongings.

She said she was angry to discover that lab workers for the medical school, said drug tests are administered to “certain employees as required by law,” but she confirmed that workers in the lab where John and McCracken worked were not monitored regularly.

Woessner described her daughter as a “superstar” and said “everything she did, she did well.” She started playing softball at age 7 and continued on a team in Baltimore. She played the clarinet in her high school band and embraced the Native American heritage of her father’s family. She graduated from high school early and enrolled in Cornell University at the age of 17, majoring in biology.

She met McCracken at Wake Forest University as they worked toward doctorates in their shared field of interest, drug addiction. She earned a doctorate in physiology and pharmacology.

She moved to Baltimore in 2006. McCracken left the university at Pittsburgh three months ago to join her. John worked on projects involving schizophrenia and drug use, and last year led a neuroscience discussion on “This is your brain on drugs.”

Woessner said she met McCracken several times and that she regarded him as “polite, intelligent, articulate” and someone “who loved my daughter.” They planned to live together for a year before marriage, and, she said, McCracken would have made a “perfect son-in-law.”

He wasn’t passionate or romantic, she said, but worked hard and seemed happy to be in the same profession as his girlfriend. Their red-brick Dover Street rowhouse was just a few blocks from the university.

It is there that police said John and McCracken led a life that the young woman’s mother never saw. McCracken told authorities that he and John injected themselves with buprenorphine and morphine. Police said they had turned their unkempt house into an indoor marijuana farm, with grow lights and fans vented with aluminum dryer hoses. Police said they found pills in bags, at least 20 bongs, 30 marijuana plants growing up to two feet high and more packed and stored in Mason jars.

According to court documents, McCracken gave police a detailed account of what happened Sunday, saying he and John soaked two buprenorphine pills in water before filtering and filling two syringes each with 1 mg doses of the drug. He said John, who has asthma, injected first and immediately had trouble breathing. He helped her use her inhaler, and then dialed 911.

She got to the hospital at 6 p.m. and dies 49 minutes later. McCracken said he didn’t get a chance to shoot up because John had already gone into distress. Police found her syringe in the living room of the house.

McCracken told police that he didn’t think John overdosed, but instead injected a bad batch of drugs. Police said results of toxicology tests to determine how John died are pending.

Woessner said she met with McCracken on Tuesday and described him as “very upset, because they were playing, they were doing what couples do. This was not an intentional thing.”

Just the same, she does not want him at her daughter’s funeral on Saturday. She said some relatives are angry with hi, and with what happened, and  wants the service to be a place “where I hope to celebrate her life.”

Woessner repeated that she doesn’t blame the boyfriend but said, “I say to God, ‘I hope that Clint can someday find some peace with this.’ “

http://morningsentinel.mainetoday.com/view/columns/7014571.html

Everything wrote in this article is the opinion of the author , NOT me.

Kennebec Journal Morning Sentinel

Question #5:  An Act To Establish the Maine Medical Marijuana Act. “Do you want to change the medical marijuana laws to allow treatment of more medical conditions and to create a regulated system of distribution?”

We recommend a “no” vote on this measure.

Medical marijuana poses a series of difficult legal and ethical questions. The medical and law enfrocement communities are opposed to its use, while some patients swear that it helps them.

And while Maine and other states have legalized medical marijuana through citizen-initiated referendums, having it and selling it remains a violation of federal law.

The measure before Maine voters would create a system of dispensaries to distribute medical marijuana and extend the number of illnesses it is authorized to treat.

We are concerned about the opportunity for diversion that this would create. What we’ve seen in recent years with prescription drugs and clinic methadone is that any medication distributed for legitimate use can end up in the wrong hands.

While doctors, pharmacies and clinics have made great strides toward cutting down diversions, we are afraid that a seperate medical marijuana distribution system would create a conduit for drugs to reach the rest of the community.

While some patients, parti9cularly those on chemotherapy who have lost their appetite for food, say they benefit from medical marijuana, we are skeptical of supporters’ claims that it is a good medication for a dozens of illnesses.

Ultimately, this is a federal issue and should be resolved in Washington, not Maine. Mainer’s should vote “no” on this measure.

Everything  wrote in this article is the opinion of the author, NOT me.