Crushing Medication Is Dangerous

Crushing psychiatric medication can come with serious risks. The way a medicine is dispensed is important. It determines whether or not the patient achieves any therapeutic advantage. It can also interfere with and exploit the adverse effects experienced by the patient.

So, naturally, I was upset when my loved one, an inmate at the Comanche County Detention Center in Oklahoma, told me the jail was crushing the medication of the women who are incarcerated there.

More than eight hundred people are waiting for drug treatment in Oklahoma. Many of them are in legal situations involving the court. Many of them also struggle with mental illness. My loved one struggles with Bipolar Disorder and addiction.

The Office of Diversion Control and the Drug Enforcement Administration (DEA) have policies in place which serve to protect vulnerable populations from such practice, including inmates. Oklahoma jails should be upholding the law.

The DEA Practitioner’s Manual stipulates that prescription medications are only to be given in accordance with the directions of the appropriate practitioner who has prescribing authority. Crushing tablets or opening capsules contrary to the prescribing practitioner violates the DEA’s assertion. It also places my loved one and every other inmate at risk. Because my loved one has had bariatric surgery, those risks increase even more. For bariatric patients, the “bioavailability of crushed medication can differ substantially compared to the same medication swallowed whole” (Rosko, 2011).

My friend has been in jail for over sixty days. She just saw the doctor today. On top of battling Bipolar Disorder, she has been detoxing from methamphetamine without any medical assistance. Now, she is starting new medication she has never tried before, and no attention has been given to the fact she had a Gastric Bypass and will absorb the medication at a different rate than most people. Yet, the jail can crush her pills without a written order to do so and consequently place her at risk of psychosis, suicidal ideation, stomach difficulties, cardiovascular problems, and even death.

If she wants to avoid that risk, she will have to ask the doctor to provide the jail with a written order not to crush her medication. It can take up ninety days for them to process her request to see the doctor again. In the meantime, she’s forced to consume the medicine as the jail demands. She waits for a bed. She waits for real help and real treatment. She waits with others who fight serious mental health conditions and who don’t even know their mental stability and well-being are at risk.

Like her bunkmate who takes quetiapine (Seroquel), which is crushed by the county jail. A study in 2008 confirmed a “widespread ‘abuse’ of quetiapine by inmates in the Los Angeles County Jail” (Tcheremissine, p. 740).  Quetiapine has street value and is sought out when other stimulants cannot be obtained. I wonder if workers at the Los Angeles County Jail crush the medication of their inmates without the direction of a physician, too. If so, I wonder if attempts to limit its abuse by way of presenting the drug in the exact way one would abuse it hurts or helps.

A report by Harvard Medical School confirmed that “stimulants used to treat ADHD have some potential for abuse because crushing and snorting (snuffing) them can produce a cocaine-like high” (Harvard Mental Health Letter, 2016). For inmates who struggle with addiction, I wonder how being forced to take crushed medication makes them feel. One might infer, it could and/or would trigger them back to the times they crushed medication while actively using illegal drugs.

It is one thing for Oklahoma to acknowledge that residents have a serious need for mental health and addiction treatment. It is another (completely unethical) thing to know and neglect the fact that those who are supposed to be helping fix the problem are fueling it instead and, in turn, placing themselves, the public, and our loved ones at risk.

It is unacceptable and it is dangerous. It must change. Lives depend on it.


References

Cosgrove, J (2017). Seven things to know about SQ 780, 781. The Oklahoman. NewsOK.com. Retrieved from http://newsok.com/article/5539223

Harvard Mental Health Letter (2006). ADHD update: new data on the risks of medication. Harvard Health Publications, Harvard Medical School. Retrieved from http://www.health.harvard.edu/mind-and-mood/adhd-update-new-data-on-the-risks-of-medication

Rannazzisi, J., & Caverly, M. (2015). United States Department of Justice Drug Enforcement Administration Office of Diversion Control “Practitioner’s Manual: An Informational Outline of the Controlled Substances Act” 2006 Edition.

Rosko, T. (2011). Psychiatric medications and weight gain: a review. Bariatric Times, 8(3), 12-15.

Tcheremissine, O. V. (2008). Is quetiapine a drug of abuse? Reexamining the issue of addiction. Expert opinion on drug safety, 7(6), 739-748.

Are Oklahoma Veterans ‘Unlikely to Survive’ the Mental Health Crisis?

Leave it to Oklahoma legislators to put on a show when it comes to the state’s mental health.

At the 2016 Governor’s Veterans Services Symposium, Governor Mary Fallin padded the state’s mental health crisis with good old-fashioned Oklahoma fluff.

We have increased access to mental health and established the Oklahoma Suicide Prevention Council.

As she stood to speak on behalf of the men and women of my state who have served this country and those we have lost, I was angered and insulted on behalf of every Oklahoman who struggles with mental health, especially our veterans.

The lives of our loved ones depend on the changes Oklahoma politicians create. Do they really think we do not notice when doors are open or closed or when we invest more in our roads than we invest in the people who pay them to stand in that office?

Trust me, we notice when our veterans sleep on the street.

What Governor Fallin meant by “increased access” is that Oklahoma House Bill 1697 was passed, permitting her to sign the Labor Commissioner Mark Costello Act into action. What she meant to do was pat herself on the back.

Meanwhile, those receiving state-funded services through the Oklahoma Department of Mental Health and Substance Abuse are at risk of being legally compelled to shove pills down their throat. Whatever happened to that “recovery-oriented” approach?

The Substance Abuse and Mental Health Services Administration defines recovery as “a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.”

Yet, if the original House Bill 1697 had been passed, every Oklahoman who struggles with mental health would have lost the right to live a “self-directed” life and make their own healthcare decisions. That right based on a few flexible words, which leave Oklahoman vulnerable.

As outlined in The Oklahoman, for a person to qualify under the terms of this act, he or she must be,

‘Unlikely to survive’and ‘unlikely to participate in treatment.’

I struggle with mental health. 

I also currently receive state-funded mental health services. When Oklahoma cuts nearly 24 million dollars from the state’s mental health budget within six short months, leaving more than 73,000 people without access crucial life-sustaining services, it makes me concerned about survival. Not just for myself, but also for 23,750 Oklahoma veterans living below the poverty line and depending on the state’s mental health services to help them survive. So, let’s get real about mental health and stop mucking around!

We cannot afford for our Governor to cover up the blood our veterans have spilled, just so her political agenda and reputation can stay sound. We also cannot afford to regulate mental health changes introduced by former

We cannot afford for our Governor to cover up the blood our veterans have spilled, just so her political agenda and reputation stay sound. We also cannot afford to regulate mental health changes introduced by former government officials driven by the grief of losing a child; no matter how tragic it was (or how heartless I sound!).

In a recent review of Oklahoma’s mental health crisis and an interview State Mental Health Commissioner Terri White, Fox News reported, “one in four people struggle” with mental illness, and Commissioner White expressed,

Treatment works if you can get in the door.

Yet it seems like the only people who are “unlikely to participate” in treatment are the very people who should be opening should be opening that door.

Taking control away from those who receive or are in need of mental health and substance abuse services does not increase access to care.

It increases fear.

Consumers who receive mental health services will be more unlikely to communicate when there is a crisis or they are in need of higher-level services, out of fear of state-controlled treatment, rather than recovery-based, trauma-informed care.

It sends the message to those waiting for help or in need of care that if they get involved with the Oklahoma Department of Mental Health and Substance Abuse Services, they might be deemed “unlikely to survive” and forced into state-controlled psychiatric care.

It silently exposes incarcerated individuals to the possibility of misuse or abuse by law enforcement or other court-appointed officials in charge of behavioral health services while under state care.

The Costello Act sends a message to those who do not struggle with mental health about those of us who do. It sends the message that people with mental illness are dangerous, unstable, and should be reprimanded and feared.

It fuels every stigma associated with mental illness that victims, survivors, and advocates have been trying to shatter for years!  More importantly, it slams doors. Doors we should be racing to open. Terri White puts into perspective,

Commissioner Terri White puts things into perspective,

We should absolutely be concerned that the suicide rate is going to begin to climb back up again in Oklahoma.

The Oklahoma suicide rate already surpasses the National average by nearly 5 percent. One in every five suicides is someone who put his or her life on the line to fight for our country, to fight for this state, and to keep us all safe.

So, I just want to say to the leaders of this state, how many more lives will be lost while you feed us lines about increased access to services you are cutting state funding for?

I say not one more! Rise up, Oklahoma. It is time to secure our survival.

Their Hashtags Are Trending Now. Will We Listen?

I am an Oklahoma woman. One small voice in the middle of the Bible Belt, in a city known as the Heart of Oklahoma. I used to believe this was as far as my voice could ever reach. Then, I found out I was pregnant.

Nine days before my daughter’s birth, my partner left and never returned. I could have succumbed to the pain and anger I felt, but I didn’t. I had my first child, moved homes, became a college student for the first time and discovered the meaning of being called “Mom.”

That’s when I realized my voice could reach further than I had imagined — it must.

My daughter is 1-year-old, and every day, I grow more fearful and worried about what her future might hold. If something happened to me today, who would stand up for my daughter tomorrow? Who would protect my child for me?

This week, I realized, no one will stand for my daughter unless she becomes another hashtag that goes viral.

#OKGirls

Yesterday, Stacy Wright and Danielle Brown led a walkout and protest to present the Norman High School administration with an urgent call-to-action and one very real message:

We will stand for our daughters because you didn’t.

While speaking with Stacy, the voice of the mothers, she emphasized their anger and shock at the lack of action taken by the teachers and other members of the administration.

She expressed that the #YesAllDaughters viral campaign is not about the way the Norman Police Department is handling the investigation; it’s about the school allowing the victims to be bullied. Bullied to the point where they no longer felt like they could return to the classroom.

By the end of the protest on Monday, three victims became four victims. Another one of our daughters became a victim of violence.


#Ferguson

On August 9, Lesley McSpadden lost her son, Michael Brown. After the decision to not indict police officer Darren Wilson who shot and killed Brown, McSpadden reacted to news that her son will not receive justice with the same intensity and emotion to the ruling.

As she screamed and wept in disbelief and anger, millions of us stood and raised our hands and voices along with her.

When her son hit the ground in a storm of unmerited violence and bullets, the people of Ferguson, MO learned that their voices can reach further than their hometown — they must.


#HandsUpDontShoot

On Saturday, the parents of Tamir Rice sat in the hospital with their 12-year-old son. They sat beside him, hoping and praying for God to spare his life, after he was shot two times in the chest by a police officer.

Tamir had responded to police with a childlike response; he put his hands down to his waistband and pulled out his fake gun. Even the officers of the department confirm it was never aimed at police.

On Sunday, those parents mourned the death of a son. Another one of our children becomes a victim to violence.


This is our culture.

Now, news networks are careful to specify “rookie cop” when telling the public how another one of our children lost his life. As if being a rookie makes it alright.

As if we won’t notice the black demographic that’s been targeted over and over, while we pretend the Civil Rights Movement erased bigotry, racism and hate from our nation.

Schools hide behind politics and professional agendas after failing to protect the students, while getting paid from the pockets of the parents of children they are obligated to protect. They blame the victims. They laugh at the students. They ignore the bullies and the rumors they hear in the hall.

Police officers gun down our children and then justify it:

Law enforcement personnel must frequently make split-second and difficult decisions.

You’re damn right, we’re angry!

So, how do we respond?


They’re Our Children!

Violence is trending, and there’s no hashtag to say it, so allow me.

We have a culture of violence and a tolerance of injustice.

We spend a lot of time acknowledging gender roles and fighting for rights: “Stop the violence against women!” But, we forget our children are boys and girls. Children are children.

When one child suffers, as parents who have held the same small hands and loved the same small hearts, we should be front and center when it comes to speaking out against any and all violence.

Black or white, boy or girl, teen or toddler, well-behaved or not, every child depends on our voice. We are the parents.

We’ve been so busy sticking to one cause or side for so long when it comes to the subject of domestic violence, we’ve neglected to see the bigger picture. We have tunnel vision when it comes to the stats.

Domestic violence affects 12.7 million people each year — men, women and children, alike. Violence doesn’t discriminate; it has no lines. The corruption is not in the gender, it is in the people.

It’s time for men and women to drop their battle signs and hold up a new one:

NO MORE CHILDREN. NO MORE VICTIMS. WE ARE PARENTS.

I stopped supporting the fight to end violence against women. It’s time to end violence against all people.