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CSC withholding info: prisons watchdog

Correctional Investigator of Canada Howard Sapers speaks during a news conference in Ottawa on November 26, 2013. Federal correctional authorities are getting in the way of an investigation into drug-prescribing practices for inmates by withholding relevant information, Canada
Correctional Investigator of Canada Howard Sapers speaks during a news conference in Ottawa on November 26, 2013. Federal correctional authorities are getting in the way of an investigation into drug-prescribing practices for inmates by withholding relevant information, Canada's prisons ombudsman says. Correctional Investigator Howard Sapers says the failure to turn over the material requested by his office is particularly galling given that Correctional Service Canada released the data to a media outlet. THE CANADIAN PRESS/Adrian Wyld
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By Adam Miller, The Canadian Press

Federal correctional authorities are getting in the way of an investigation into drug-prescribing practices for inmates by withholding relevant information, Canada's prisons ombudsman says.

Correctional Investigator Howard Sapers says the failure to turn over the material requested by his office is particularly galling given that Correctional Service Canada released the data to a media outlet.

"It certainly raises questions in my mind when I see that there are in fact other documents that provide pertinent information to an investigation that were not previously shared with me," Sapers said in an interview.

"It slowed things down and that's always frustrating."

Sapers launched his investigation in April after documents obtained by The Canadian Press and CBC revealed that more than 60 per cent of female inmates across the country were being prescribed powerful anti-psychotic drugs.

He has since expanded the probe to look into CSC's compliance with his information requests after the agency missed key documents on the off-label prescription of Seroquel, the brand name for Quetiapine — an anti-psychotic drug strictly recommended for the treatment of schizophrenia and bipolar disorder.

"Why were they not as responsive the first go round?" Sapers said. "I don't know. We're trying to find out."

That key documents were not given to his department is concerning and speaks to transparency issues, accountability issues and compliance with the law, Sapers said.

However, he said he was unable to determine whether the failure was deliberate or a data-management issue in the large, far-flung and complex organization that is Correctional Service Canada.

CSC would not comment directly on Sapers' concerns but said in a statement it works with the Office of the Correctional Investigator "to address and resolve areas of mutual concern."

Seroquel has a history of being used off-label as a sleep aid. Some of its side effects can be fatal and include diabetes, hyperglycemia, constipation and intestinal obstruction, and complications from blood clots, according to Health Canada.

In the United States, Seroquel is no longer being prescribed to prisoners in a number of states, including California, Ohio and New Jersey, after reports of widespread abuse of it by inmates.

Despite the potential problems, internal prison data obtained by The Canadian Press after an Access to Information request but not passed on to Sapers show seven per cent — or more than 1,000 — of the 14,000 federal prisoners in Canada in November 2010 were being prescribed Seroquel.

Sapers says he asked the agency to turn over all Seroquel-related documents, but he failed to receive key documents CSC provided to The Canadian Press, including a 2010 memo that shows officials were aware of the dangers of the drug.

"More and more anecdotal evidence is emerging to support the abuse potential of Quetiapine," the internal memo states.

"The increased use of Quetiapine can in part be attributed to its off-label use."

Another internal CSC memo dated Feb. 7, 2011 — also obtained by The Canadian Press — raised concerns about the drug's off-label use and recommended it be prescribed to inmates solely for the treatment of schizophrenia and bipolar disorder, as recommended by Health Canada.

"Gradual withdrawal over a period of at least one to two weeks in advisable. All planned discontinuations must be completed by June 30th, 2011," the memo read.

Figures from 2014, three years after the policy change, show that 539 of more than 15,000 inmates received Seroquel — a sharp decline from 2010.

The agency has refused to comment in the past about the prescribing of the drug in federal institutions prior to the June 2011 policy change. However, a spokeswoman for CSC admitted last week that "Seroquel was also prescribed for insomnia and depression" prior to that year.

"Medications provided by CSC are regularly reviewed, and additional criteria are occasionally put in place," Sara Parkes said in an email.

CSC has also said in the past that it could not provide a breakdown of the number of prisoners on Seroquel by gender or prison, claiming it did not have the information or the ability to track it.

"Then we see in a document that in fact they give an estimate of usage, which means that somebody must have been counting and collecting that information," Sapers said.

"So there's certainly an inconsistency in the response and again it's something we've questioned and are pursuing."

The off-label use of the drug raises issues regarding medical treatment of prisoners and the steep drop in Seroquel prescriptions shows only a small percentage were "appropriately prescribed," Sapers said.

"This off-label use of this prescription drug happens in the community as well," he said. "That's no excuse for CSC to condone a practice which they state at the outset they don't engage in."

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