Characteristics of Inmates Who Misuse Prescription Medication

Abstract

Substance use disorders are common among incarcerated individuals, and prescribed medications have been reported as abused, diverted, or otherwise misused in correctional settings. We conducted a retrospective chart review of electronic medical records and reports on institutional charges for misuse of authorized medication by inmates in the New Jersey Department of Corrections between 2003 and 2013. The most frequently cited medications for misuse were gabapentin, diphenhydramine, clonidine, and ibuprofen. When compared with the entire current inmate population, subjects were more likely to have any history of a substance use disorder, to be in treatment for a mental illness, to have any diagnosis of antisocial personality disorder, to have any history of malingering, and to be prescribed a greater number of medicines. Prescribers in correctional settings should be aware that medications not traditionally prescribed by a psychiatrist may also be misused, and caution should be taken to manage this risk.

Assessing symptom exaggeration of psychopathology in incarcerated individuals and mentally ill offenders within forensic contexts

“…Trihexyphenidyl (Tamburello et al, 2017). Quetiapine is currently neither a controlled medicine nor categorized as a narcotic.…”

“…Consistent with Cunningham (2006), it was suggested that inmates with a history of being on medication for psychiatric disorders often abuse those medicines, which also may be traded in prison. The medicines that are found and commonly used in prisons are Quetiapine, Olanzapine, Gabapentin, Bupropion, and Trihexyphenidyl (Tamburello et al., 2017). Quetiapine is currently neither a controlled medicine nor categorized as a narcotic.…”

“…In this regard, this type of delay in the proceedings can result in an even more lengthy jail term for the offender; and as a result, more correctional resources will be wasted. Furthermore, malingering inmates may take part in other forms of harmful behavior such as through the abuse of drugs or by selling drugs to other inmates (Tamburello et al., 2017). An assumption has been made that inmates who have received prior treatment (those previously on medication) for both physical and psychiatric illnesses are likely to malinger in the hope of receiving the medicine again.…”

A global review of prison drug smuggling routes and trends in the usage of drugs in prisons

“…The misuse of prescription medications apart from OST medications, such as tranquilizers, antidepressants (mirtazapine), benzodiazepines, antipsychotics (quetiapine, olanzapine), anticonvulsants (pregabalin, gabapentin), and even paracetamol (acetaminophen), has also been reported to be an increasing problem in many prisons, particularly for women (Bi‐Mohammed et al, 2017; Duke & Trebilcock, 2022; Hampton et al, 2015; May et al, 2019; O'Hagan & Hardwick, 2017; Penfold et al, 2005; Rousselet et al, 2019; Sahajian et al, 2017; Tamburello et al, 2017; Zurhold et al, 2005). Women have been found to be more likely to misuse prescription medications than men in both prisons and the community (UNODC, 2021).…”

“…After 2013, the reported use of heroin in prison declined, while the use of buprenorphine, which is a common opioid substitution treatment (OST), increased. Other prisons around the world have found an increase in the misuse of OSTs, particularly buprenorphine, as well, likely due to them being less expensive than heroin; being more easily obtainable than heroin due to the possibility for the diversion of prescription OST medications and availability of formulations that can be more easily smuggled, such as sublingual films and tablets; often requiring smaller quantities; and the widespread belief among prisoners that buprenorphine is not able to be detected in urine drug screens (Bi‐Mohammed et al, 2017; Mjåland, 2014, 2016; Mohammed et al, 2016; Monico et al, 2021; Mravčík et al, 2018; Penfold et al, 2005; Plugge et al, 2009; Rousselet et al, 2019; Tamburello et al, 2017; Tompkins, 2016; Tompkins et al, 2009; White et al, 2016; Wright et al, 2014).…”