Rampant use of meds in jail

Photo: The Canadian Press. All rights reserved.

Dr. David Juurlink, head of the division of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre, speaks during an interview in Toronto on Friday, April 4, 2014. THE CANADIAN PRESS/Michelle Siu

Canada's prison watchdog has launched an investigation into the prescribing practices in federal prisons, after it was revealed that more than 60 per cent of female inmates across the country are receiving psychiatric medication.

A joint investigation by The Canadian Press and CBC has learned that in August 2013, of 591 female federal inmates in five correctional institutions, 370 were being prescribed at least one psychotropic medication, drugs that impact mood and behaviour.

When separated by region, the prescription rate jumps to almost 75 per cent in prisons such as the Nova Institution for Women in Nova Scotia, the Joliette Institution for Women in Quebec and the Fraser Valley Institution for Women in British Columbia.

That is a significant increase from 2001, when the prescription rate was 42 per cent, according to a study by Correctional Service Canada that raised concerns about what it called "overprescribing and multiple prescribing of psychotropics" in some prisons.

The 2013 data was collected by Howard Sapers, the Correctional Investigator of Canada, who first looked into the issue last summer, after the CSC told The Canadian Press and CBC that the department did not keep records of medications prescribed to inmates.

Former prisoners and their advocates have been complaining for years about what they call the overmedication of inmates. They claim that quetiapine — an antipsychotic drug strictly recommended for the treatment of schizophrenia and bipolar disorder — is being prescribed to female prisoners as a sleeping aid.

When asked for comment, the CSC would only say that quetiapine — available in Canada under the brand name Seroquel — is prescribed to inmates solely for the treatment of schizophrenia and bipolar disorder, as per Health Canada's recommendations.

But an internal CSC memo, obtained through as Access to Information Request, shows there was a concern in 2011 that quetiapine was being prescribed for unapproved uses, often known as off-label uses.

"In an attempt to better control the circulation of quetiapine within CSC, the National Pharmacy and Therapeutics Committee has recommended that quetiapine be only funded for its official indications: schizophrenia and bipolar disorder," the memo reads.

"Gradual withdrawal over a period of at least one to two weeks in advisable. All planned discontinuations must be completed by June 30th, 2011."

Jennifer Kilty, a criminology professor at the University of Ottawa who specializes in the treatment of incarcerated women, said the idea that the majority of women in prison — in some cases 75 per cent of them —are mentally ill to the point that they need some form of psychotropic medication is "absolutely outrageous."

Sapers says CSC is co-operating with his office's investigation and he hopes to have some preliminary findings soon.

"Those preliminary findings will then help guide us in decisions about more in-depth investigations."