2nd Gregg County death from Methadone withdrawal spurs calls for uniform policy on prescription drugs in jails

Another Gregg County Jail inmate has died after being denied prescribed Methadone - the second such case in six months - raising the question of whether policies on access to prescription drugs should be standardized, the TV station KYTX reported last week.

30-year-old Micah Garner's death is raising new questions about the county's drug policies.

Individual counties have the right to decide which medications are allowed inside their jails and counties around East Texas are handling that decision differently.

The Gregg County Sheriff's Department gave CBS 19 a copy of their drug policies. Medical workers inside the Gregg County Jail have two lists they're working from.

One of them lists drugs that can be administered to inmates. It includes things like allergy and cholesterol medications, even HIV treatments.

The other one contains 26 drugs banned from the jail. It's made up mostly of narcotics and other prescription drugs with the potential to affect an inmate's mood and motor skills.

Methadone, the drug both [Amy} Cowling and Garner were on, is specifically mentioned. The document also says detainees who enter with any of the drugs should have them confiscated.

In Smith County, they do it differently. Instead of a specific written drug policy, a doctor examines the inmate and makes an individual determination about what drugs are appropriate to give while they're in jail.

In Gregg County, a doctor does examine the inmates but is not allowed to go outside the list of approved medications. Sheriff Maxey Cerliano confirmed that list was drafted by a doctor, and not by the department itself.

Reporter Field  Sutton quoted an ER doc explaining that methadone "is typically prescribed for recovering drug users, such as heroin addicts. Sometimes it's also given to chronic pain patients." While withdrawal wouldn't normally lead to death, says the doctor, it can when it aggravates other health problems. Neighboring Harrison County (Marshall) also bans Methadone in the jail.

Sutton predicts the deaths may spur legislative action in 2013: "There's a growing movement to get state lawmakers to create a single policy for methadone inside jails and prisons. No bills have made it to the capitol addressing the issue, meaning it would have to be taken up in the next session."

MORE: See the original complaint of a lawsuit filed in federal district court by Amy Cowling's parents as a result of her death in the Gregg County Jail.

'The DNA's Over There... Right Next to the Jelly: The Problems with the Preservation of Evidence in Texas'

The headline of this post is the title to a note in the Texas Tech Administrative Law Journal by Danielle Badeaux, described on SSRN as follows:

In “The DNA’s Over There… Right Next to the Jelly: The Problems with the Preservation of Evidence in Texas,” author Danielle Badeaux discusses the embarrassments that result from Texas’s preservation and storage methods for DNA materials. First the author argues that the ambiguities in the statutes governing DNA evidence lead to confusion. The article next describes the loss of evidence due to misplacement, mishandling, and degradation of samples that were preserved incorrectly. Additionally, the author examines how Texas’s guidelines for evidence retention make it almost impossible to appeal for testing of the evidence if more than a decade has passed.

Badeaux proposes several changes to make the system more efficient. First, the author argues that other states have statutes in place that make the guidelines much more specific and remove much of the ambiguity and confusion present in the Texas statutes. Next, she states that Texas could also revise the statutes that are currently in place to remove confusion. Finally, Badeaux suggests that Texas could leave preservation efforts up to each individual county and require that they have preservation methods in place.

According to the note, Texas law "does not clarify what constitutes biological evidence, who maintains preservation of evidence, who maintains responsibility for ensuring compliance with the statute, or how to preserve the evidence. Moreover, outside the context of biological evidence, Texas does very little to ensure the preservation of evidence."

Gregg County Commissioner Darryl Primo comes off as a hero in the story, pushing to improve evidence retention in Longview despite strong resistance from local officials who ultimately thwarted his efforts. When Primo began calling other jurisdictions about their practices: "Some of the counties he phoned had no preservation policies at all, while other counties were preserving evidence by sticking it on unused, empty shelves. The prevailing theme was that many of these counties had no idea who should store this evidence. As a result, they had no actual record of the location of the evidence. As Primo pointed out, this posed a significant problem when county officials began to retire."

When Primo looked into what was going on in his own county, "he discovered the biological evidence stored in a mini-fridge. The biological evidence sat next to cokes and candy bars. The refrigerator had no padlock on it. No log existed for people who dealt with the evidence. The office door had no lock. No one monitored the temperature, and no one secured the office." Badeux suggests minimalist standards requiring storage at sufficiently cold temperatures, making technicians wear gloves, and requiring a written log should be added to Texas evidence preservation statutes.

See related Grits posts:

• Senate bills encourage retention, testing of old rape kits, DNA evidence
• Dallas DNA exonerations expose evidence retention flaws
• 'Unanalyzed evidence held by law enforcement agencies'
• Evidence retention failures thwart pursuit of innocence claims
• Proving innocence, solving cold cases frequently depends on DNA collection, preservation

Longview jail death likely due to withdrawals from withheld medication

Autopsy results are in regarding the Gregg County jail death discussed on Grits here - a story that's received excellent coverage from the Longview News-Journal. The "autopsy report for 33-year-old Amy Lynn Cowling revealed her cause of death was 'probable' seizure due to methadone and prescription drug withdrawals." Another News-Journal story added this pitiful tidbit: Cowling was "found unresponsive in a jail separation cell ... kneeling in a praying position beside her bed before being removed and declared dead a short time later." Further:

Investigations into the death found jail logs had been falsified, but it was unclear ... whether the check sheets were among the falsified documents.

Gregg County officials arrested two former jailers in connection with the alleged falsifications. One was said to have occurred in November, another was in relation to Cowling’s death. A total of four jailers were fired as a result of the death investigations, including the two who were arrested. Another resigned.

Cowling's death was particularly tragic because her incarceration was so pointless: A single mother of three, she was arrested Christmas Eve during a traffic stop where troopers discovered outstanding traffic warrants from 2007 in two neighboring counties. She couldn't pay so remained in jail where she died five days later.

Investigating neglect in Lonview death of mother jailed for traffic warrants, denied seizure medication

Brandi Grissom has a feature at the Texas Tribune on the disturbing number of recent inmates deaths at the Gregg County Jail in Longview - nine since 2005 in the smallish East Texas county - focusing particularly on the most recent instance, where a young mother locked up for traffic warrants died after her seizure medication was denied to her. The Texas Civil Rights Project recently complained that poor healthcare in Texas prisons constituted a "secret death penalty," and whether that provocative accusation is justified, certainly in this case it's easy to argue poor jail healthcare turned into a death penalty for Amy Lynn Cowling. And she's not the only one.

Rather than excerpt and comment, those interested should go read the whole thing. Well done, Brandi, and as an aside this is the type of journalism I hoped we'd see from the Tribune when it launched with such deep pockets and its admittedly impressive cadre of writers - not just reporting the same stuff everybody else does from the capital but regional investigative features that folks like me with no resources can't do from Austin, and which local reporters don't have either skills, resources or often editorial backing to perform.

That said, I should add that the Longview News Journal arguably is the best small-town paper in the state (an accolade I don't grant them lightly), and their coverage of this topic has been very good, see:

• Deadly lockup: Young mother's death should prompt review of jail procedures
• Family: Woman who died in lockup got death sentence for speeding 
• Inmate death spurs broader jail probe
• Dead inmate's medical records in 'legal limbo'
• Woman dies in Gregg County jail, family says medication was denied
• Inmate who died was unresponsive after seizures, jailer says
• Second Gregg jailer charged in connection with inmate death
• Jailer charged in inmate's death, four others fired as investigation continues
• Gregg county jailer arrested in connection with inmate's death
• Inmates not guaranteed own prescription medications 
• Inmate's meds weren't on the approved list
• Gregg County jail back in compliance but Upshur County jail isn't
• Woman found dead in Gregg County jail, sheriff and Texas Rangers investigating
• Jails across Texas routinely found noncompliant

This tragic story has benefited from some excellent journalism, which is unusual when such things happen to say the least. So I don't have much to add on the subject - go read what the reporters who actually researched the topic have to say.

Longview SWAT team raids wrong home

Radley Balko called it "another isolated incident": In Longview, a SWAT team broke down the door of the wrong home last week in an apparent no-knock raid. The News Journal reported that "officers apparently were distracted by 'known suspects' in front of a home." The real targets were next door - alleged drug dealers who were arrested later the same evening without incident, so clearly in this case SWAT wasn't necessary to capture the actual suspects. In an editorial yesterday, the local paper declared that "local officials could do themselves — and taxpayers — a favor by inviting an outside, totally unbiased agency to come in and do their own investigation."

As Balko wrote in the executive summary to a white paper for the CATO Institute on the subject in 2006:

These increasingly frequent raids, 40,000 per year by one estimate, are needlessly subjecting nonviolent drug offenders, bystanders, and wrongly targeted civilians to the terror of having their homes invaded while they're sleeping, usually by teams of heavily armed paramilitary units dressed not as police officers but as soldiers. These raids bring unnecessary violence and provocation to nonviolent drug offenders, many of whom were guilty of only misdemeanors. The raids terrorize innocents when police mistakenly target the wrong residence. And they have resulted in dozens of needless deaths and injuries, not only of drug offenders, but also of police officers, children, bystanders, and innocent suspects.  

One of the key recommendations in that CATO white paper was to "Return SWAT Policing to Its Original Function—defusing those rare, emergency situations in which a suspect presents an immediate threat to someone’s life or safety. SWAT teams should not be executing search or arrest warrants, conducting routine police patrols, or engaging in similarly proactive police work. SWAT teams should never be used to serve search warrants on drug offenders with no history of violence." I couldn't agree more.

SWAT teams were originally inspired after the Charles Whitman UT-Tower shootings here in Austin, but increasingly they're used for execution of routine arrest warrants instead of intervening in already violent situations, initiating violence instead of quelling it. Here's an interview with Mr. Balko from earlier this year lamenting the unnecessary trend toward SWAT teams' overuse.

Research needed to tell if fewer arrests increase crime

Would arresting fewer low-level offenders increase crime? In the wake of Hurricane Rita, researchers have a chance to empirically measure that notion -- I'd love to see somebody in academia take up the project.

Rita's aftermath affords an almost unique chance to research the impact of reducing low-level arrests on crime rates. The Beaumont Enterprise reports that the Orange County jail failed inspection and still cannot re-open ("Orange County jail fails inspection, "Dec. 2). "Since the jail has been closed, law enforcement officers have had few spots to house criminals so arrests are way down," the paper reported. Grits earlier noted that officials in Gregg and Chambers Counties are in the same boat, making fewer arrests, especially of non-violent offenders, because of jail overcrowding.

So, during the period when those jurisdictions have reduced arrests, did the number of crimes reported increase, decrease, or stay about the same? I don't know the answer to that, though I haven't heard of any new crime wave reported in those areas. Local officials don't seem to think crime has worsened as a result: “In no way are the lives and safety of the citizens of Chambers County being put at risk,” [Chambers Sheriff Joe] LaRive said. “We’re still doing our job — we’re still protecting the public.”

To tell if that's really true, researchers would have to examine local records about the number of crimes reported before and after the hurricane for counties that reduced arrests. I'll bet he's right, though -- I've long suspected that a lot of low-level arrests, especially for non-violent offenses, aren't really improving public safety. With a little research it'd be possible to find out for sure.

Rent-a-bed policy, not Rita, responsible for Gregg County jail turning away prisoners

Overincarceration at the Gregg County jail in East Texas has forced local law enforcement officials to "turn away" nonviolent offenders in the near term. Officials blamed Hurricane Rita, even though state jail population reports show the bulk of the problem was caused by their own management choices:

The city of Longview also has agreed to not arrest Class C misdemeanor warrants for about 15 days while the jail grapples with an overcrowding situation spurred by the addition of 30 inmates from Southeast Texas prisons.
The problem was compounded when the state's criminal justice department canceled all jail transports due to Hurricane Rita.
"We're supposed to have double digits going out last week and this week," Cerliano said Friday, noting that 95 offenders on state parole warrants were already at the jail.
"The state quit taking them, so they put us in a bind."

Those 95 offenders, though, even added to the 30 evacuees, aren't why overcrowding forced fewer arrests. Instead, Gregg County has rented out nearly half its jail beds on contract -- 234 out of a jail population of 536, according to the September 1, 2005 Jail Population report (pdf). So Gregg County taxpayers paid to build plenty of jail space for their local needs, but the county's leaders filled it up with inmates from other jurisdictions so that in time of emergency, all their extra capacity was predictably gone.

That's just bad management by the Sheriff and the Gregg County commissioners court, reducing public safety for their own community in order to generate a slush fund housing other's prisoners. (It's a good thing the Sheriff already got his $700,000 budget increase approved this year I guess.)

Across the state other counties are making the same mistake, even building new jail capacity speculatively hoping to lease beds out to the other entities in an essentially entrepreneurial fashion. Much of the boom is driven by the US Marshals Service, which must find somewhere to house defendants in the skyrocketing number of immigration cases the US Attorney in Texas' Southern District (Houston) has chosen to prosecute.

Just as President Eisenhower warned of a military-industrial complex, a prison-industrial complex has arisen that views incarceration not as a sad outcome to be avoided, but, improperly, as a venue for entrepreneurship, seemingly inspired by a weird sort of greed-driven, state-sponsored schadenfreude. What's happening in Gregg County shows that such policies aren't just cynical and soulless, they're bad for public safety.