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Gregg County Jail’s Deadly “Treatment”

Mar 27th, 2013 | Category: Lead Article

by Sarah Thomas sthomas@news-journal.com, March 24, 2013, Longview News Journal

The death of a Gregg County Jail inmate this past week has put the jail’s drug policy back in the spotlight.
The policy, under which certain prescription medicines may be withheld from inmates, was cited by his mother as a possible factor in events leading to the death of Bobby Madewell Jr., 51, who died early Thursday.
It also may have played a role in a 2010 jail death that led earlier this year to a $1.9 million settlement between the county and an inmate’s family.
Such policies, which are not uncommon, are set by the jail and not the state, said Brandon Wood, executive director of the Texas Commission on Jail Standards.
“It’s a local decision,” he said Friday. “We do require that they have a health services plan, and in that it requires them to follow doctor’s orders.”
The orders that must be followed, Wood said, are those from the doctor who oversees treatment of inmates, not the inmate’s personal physician.
Because drug policies are set at the local level, he said, some jails may allow inmates to continue receiving prescription medicines while others do not.
Jail officials on Friday declined to provide additional information about Madewell’s death at Good Shepherd Medical Center. He was taken to the hospital after being subdued by jail staff with a stun gun and becoming unconscious, Sheriff Maxey Cerliano said Thursday.
In an interview that day, Betty Madewell said jail staff told her Bobby Madewell had not been receiving his prescribed Xanax because the anti-anxiety drug is not on the jail’s list of approved medicines.
“I told them he needed his medication,” she said. “His doctor had prescribed him Xanax, and I told them he needed his Xanax or he would start having seizures.”
In an interview Friday, Dr. Lewis Browne, the Gregg County doctor who oversees inmate health, declined to discuss specifics related to Madewell’s death.
But he said most jails do not allow inmates to receive tranquilizers such as Xanax. However, Gregg County Jail’s health service plan allows librium and dilantin, also tranquilizers, to wean inmates off alcohol and Xanax. Librium is given as part of the protocol for inmates to taper off Xanax, he said, while dilantin is given to control seizures caused by withdrawal.
“We usually wait until they (inmates) show evidence that they are going through withdrawals,” Browne said. “If we see they are having problems coming off medicine, we give them something.”
The jail’s protocol for someone with a Xanax or alcohol addiction can be implemented by jail staff without calling Browne.
“If he was in withdrawals, they would’ve used the protocol,” he said.
Browne said Madewell had been placed in a separation cell and was on suicide watch because he refused to eat, a condition jail officials considered a threat to harm himself.
Browne also said inmates who enter the jail while on prescription medicines may not be using the medication properly, making it important for jail staff to wait for signs of withdrawal.
“If they weren’t taking their meds and you try to put them on these meds (librium and dilantin) you can hurt them,” Browne said.
Blood tests cannot always provide verification of what and how much inmates were taking. “You can detect certain meds but not know when they took them last or if they were taking them regularly,” he said.
Xanax, a prescription anti-anxiety treatment, is part of the drug class known as benzodiazepine. Librium and dilantin belong to the same class, and Browne said the three drugs act the same way when they enter the body.
“The advantage of the meds we give them is that they move out of the system slowly, which means it’s a gentler transition,” Browne said.
Another problem with treating inmates is that they have the right to refuse treatment.
“Xanax is the second most-abused prescription drug following hydrocodone,” Browne said.
Xanax also was involved in the claim against the county in a lawsuit stemming from the 2010 death of Amy Lynn Cowling, who died after suffering seizures while in a separation cell. In a federal lawsuit settled earlier this year, Cowling’s family had claimed she died because the jail’s policy prevented her from receiving prescription medicines, including Xanax.
Madewell had been jailed since March 12 on a bond forfeiture for charges of aggravated assault with a deadly weapon.
In a prepared statement Thursday, Cerliano said Madewell “exhibited erratic behavior about 12:40 a.m. Officers interacted with the inmate and he began to resist and became extremely violent.”
Madewell was stunned with a Taser so he could be subdued and put in restraints, Cerliano said.
“The inmate became unconscious and was immediately assisted by staff as well as medical staff on duty,” he said.
Madewell’s death is under investigation by Texas Rangers and the Gregg County Sheriff’s Office. An autopsy was to be conducted by the Tarrant County Medical Examiner’s Office.

[TJP note: Medical examiners report just came in “inconclusive.”]

Xanax withdrawal symptoms
Uncontrollable shaking
Blurred vision
Difficulty tolerating noise, bright lights or strong scents
Difficulties concentrating
Abdominal cramps, diarrhea and vomiting
Nervousness, aggression or agitation
Tingling in hands and feet
Source: National Library of Medicine

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1 Comment
Jim Butler
7 years ago

And no, they did not give me my xanax and after having two seizures i was told to call for medical the next time I was in the middle of one so they could see it for themselves. Does that make sense. It took me seven days of illness and seizures to ofinallly get better. I begged for a bottom bunk so I would not fall off the top while in a seizure. I was denied until I wrote a grievance and was put on a bottom bunk two weeks later. I too could have died. They don’t care. Montgomery county does not follow the own laws they are sworn to protect. Human rights violatians are rampent there. God help the people in that jail.