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  1. Charles Lee

    Reader Question: I have surveyed correctional facilities that do not allow any Keep On Person (KOP)medicines, to include nitro and asthma inhalers, even in medically verified instances. This is presumably for Safety & Security reasons, and instituted by custody. When questioned, the response is invariably : “If the have an attack, medical personnel will respond in time.” I have some concerns about this policy. What are your thoughts?

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      1. Cheralee

        I believe this is a difficult question. In the past we had an inmate (in one man locked down cell) go through a whole MDI in 3 days. Due to tachy and euphoria effect – he must have had a good time. We have seen pictures of a cuff key made from an inhaler canister. Our psych MD states Wellbutrin and Albuterol cause the same effect as meth in the brain leading to euphoria. We have had a patient with true angina keep 2 nitro in his cell promising to advise medical when/if he took them and why. We have also allowed a brittle diabetic to keep a few glucose tabs on person in case he crashes. Maybe it is a case-by-case basis. We do our best trying to keep our patients safe as well as the safety of others (security staff included.)

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        1. Jeffrey Keller MD

          Hi Cheralee, albuterol abuse definitely happens in corrections. I also have seen an inmate who inhaled an entire MDI canister within an hour–and became delirious and hemodynamically unstable. It certainly is a judgement call, weighing the potential benefits versus the potential harms, on when to allow inmates to KOP potentially harmful meds.

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