There are multiple schools of thought about what sort of healthcare California prisoners should receive. Some folks blurt out that convicts deserve little if any help in the way of medical services. Others believe those imprisoned should receive adequate and proper medical care and attention, and the federal courts agree. The medical care and attention (before the “feds” stepped in) had been sub-constitutional for decades.
Just because there are so-called watchdog groups observing the medical situation behind prison walls does not mean things are running smoothly. One ongoing problem in many prisons is the distribution of carry-out medication (meds prescribed by physicians) and medication taken orally in the presence of prison medical staff, such as a nurse. Wherever there are masses of humanity, there will be a need for medication. Just like anywhere else, prisoners take the gamut of prescribed drugs and medications as ordered by their doctors.
Every prison employs a different standard for distributing medications to its prisoners. The medications dispensed range from aspirin to morphine, as well as a variety of salves, balms, lotions, ointments, antibiotics, vaccinations, shots, insulin and the inventory goes on. These medications are normally passed out through some sort of slotted window or opening for “security concerns.” Some meds are brought to the prisoner’s cell or dormitory, again depending on the prison or medical facility. All medication for men and women in “administrative segregation” (The Hole) is delivered to them by medical staff.
Some of the prisons have medical and psychiatric “pill lines,” and many, if not all, are combined into one. These lines are an incident waiting to happen. There are men in prison (probably women too) who have been diagnosed with psychiatric disorders of the mind such as psychosis and neurosis. Many suffer from alternating periods of bipolar mania and mental depression. It doesn’t take much to set off these disorders. A poorly managed medication pill line causes all sorts of problems.
Pill lines have sometimes upward of a hundred prisoners (or more) in them at any given time. These prisoners are forced to stand, queued single file, for hours at times between receiving their medication before being allowed to return to their housing units. Pill lines are (in many prisons) outside in the elements such as the ones at California State Prison Solano (CSP-Solano) in Vacaville and the California Correctional Center (CCC) in Susanville.
Some prisoners line up for their medication an hour or more before pill call begins in an attempt to avoid being toward the end of the line where the wait can be hours. Because of all the medical and psychiatric reasons prisoners take medication, unpredictable (sometimes violent) conflicts ensue out of frustration. These confrontations are due to the extended periods of time these men wait for their medication. The frustration turns into irritability. The pain for which a prisoner is taking medication worsens, and the anxiety that some men experience becomes overwhelming. People begin to disrespect one another or believe they were disrespected for everything from someone standing too close to them in line to believing someone cut in line ahead of them. Who knows what the “voices” are telling some of them.
Prisoners who have had surgery, for example, even those patient/prisoners recently returned from open-heart surgery, must go out in the elements to the notorious pill line to take their prescribed medications.
In 2006, at CSP-Solano, I was forced to stand on crutches for nearly five hours with a blood-soaked bandage on my ankle while waiting for a “dressing change” after surgery. After the long wait, I was given a small gauze pad and a smaller strip of tape and told to “change the bandage” myself by a supervising nurse. To add a to the pain and frustration, I had to wait an additional two hours (while still standing on crutches) in CSP-Solano’s “Satellite Clinic” pill line before I was issued Tylenol #3s for my pain.
Another incident developed and turned violent in seconds after two men were waiting an exorbitant amount of time in the pouring rain at CSP-Solano. The first guy said, “This shit is fucked up, out here in the rain.” The guy behind him in line responded, “I guess we just got to deal with it.” Guy No. 1 without hesitation or time for thought quickly turned and commenced to kick the crap out of guy No. 2. Eventually, they were both sprayed with a powerful chemical teargas (pepper spray) and carted off before either of them was medicated.
The combination of lack of supervision by Solano’s custody staff (who sit inside the warm dry dispensary out of view of the pill line) and the unpredictable temperament of the individuals forced to pick up pain or psychiatric medication in such miserable circumstances causes these problems.
The pill line at the CCC Level II yard is not as disorganized and potentially dangerous as CSP-Solano’s but has its own problems.
In Susanville, especially during the fall and winter months, prisoners who wait in the pill line for medication are lined up on a roadway outside the dispensary. Susanville is approximately 4,400 feet above sea level on the northeast slopes of the Sierra Mountain range. Wind, rain, mud, slush and freezing cold are the elements prisoners must deal with to take their medication during the winter months in Susanville.
Exacerbating the already miserable circumstances and CCC’s pill line are the alarms that sound as many as 8–10 times per day. All prisoners must sit on the ground while an alarm is in progress, which can be from a few minutes to a couple of hours. Most of the alarms are for “frivolous” or uncalled for reasons, according to a longtime Susanville prisoner. Nevertheless, the pill line prisoners are forced to sit in the wet or freezing snow. Some men opt to suffer with pain and not take their medication to avoid the degradation they are subjected to in the pill line. Waiting an additional hour or more in the freezing cold to get back into the housing unit makes matters worse.
Some prisoners believe many of the needless alarms are more for the amusement and entertainment of prison staff than for any safety reason. Even prisoners who are senior, arthritic and mobility impaired with a range of medical and/or psychiatric problems are forced to the dirt. If a handicapped individual is too slow to sit on the ground, because of his crutches or cane slowing him down, he could possibly (and it’s happened) be sent back to his housing unit after the alarm and denied his medication.
In fact, prison appeals records reflect numerous complaints filed by prisoners regarding the pill line problems throughout the state. Try retrieving that information from any prison and you’ll be amazed at all of the meticulously tailored answers you’ll get telling you why that information is not available to you. The pill line dilemma is not unique to CSP-Solano and CCC Susanville. It is ubiquitous throughout the prison system. Some pill lines are better supervised and not out in the elements. Thirty-three prisons make up the California prison system, and reports of similar problems with medication distribution lines are many.
There are solutions to the pill line problems. Separating the dispensing of medical medication from those prisoners who take psychiatric medication would be a good start. Dispensing medication from an area with a roof or overhang, or in a gymnasium, would be another. The enclosed entrance of housing units out of the elements would solve a large part of this ongoing problem.
Many of the situations are pretty much always caused by prison custody staff where medical personnel have no say. Any prison administrators can fix the pill line problem if only they would take a few minutes to speak with those prisoners who are directly affected rather than some secondhand, word-of-mouth account.