The announcement is for “all Gold Cards” to report to the pharmacy. The loudspeaker message happens every morning – seven days a week. If the prison is in lockdown, pharmacy staff makes visits to the cells of inmates designated as “Gold Cards.” There is too much at stake …. a missed day would be a missed opportunity … an opportunity to spend taxpayer money ….
When a rabbit hole becomes a money pit … and the pit is a gold mine …
As a prison junkie
Life’s a foggy high
Jail time’s cravings seek out
A cheap drug supply
Getting the money’s hard
COVID check’s long spent
Work’s not a junkies’ style
Even with free rent
Now his drugs cost nothing
He stays zonked and fat
Medicaid buys the drugs
Through a con called MAT
M’s for medication
A T means it’s free
Just claim addiction cure
Profits guaranteed
Big Pharma needs suckers
Prisons buy in bulk
With Medicaid’s check book
MAT drugs stay in stock
These meds are expensive
Cost is their appeal
Efficacy’s foggy
But money’s quite real
The addiction cure quest
Not an honest goal
Twelve step programs ignored
Snake oil must be sold
“But it is more than drugs”
Pharma’s con boys grin
“There supporting programs
A grift for your friends”
Fake drugs and fake programs
MAT’s a fraudster hit
A false cure rabbit hole
And a money pit
Now for the marketing
Branding will be key
One thing that always works
Exclusivity
Prisons made a Gold Card
Sounds special of course
Since this is a caged place
Special can be worse
Take their Special Housing
It’s a place called SHU
How is that place special?
It holds just a few
SHU might be detention
If this was high school
The place for bad inmates
Who break certain rules
So Gold Cards are special
But not in SHU ways
Accessing high-priced dope
Earns Gold Cards their name
Every inmate Gold Card
Gets pricey drugs free
An addiction cure lie
That feeds Pharma greed
The Gold Cards are junkies
Addicts to the core
Who seek to be sober
Trying drugs once more
More drugs to fix druggies
Sounds both cute and dumb
Such absurd solutions
Now have a new home
Jail staff get extra pay
For Gold Card programs
Big Pharma sells the drugs
Just another scam
Meaningful treatment of addicts in American prisons remains as elusive as treating addiction in other settings. In federal prisons, the proven solutions which rely on a power greater than man, best articulated in the 12 steps of Alcoholics Anonymous (AA), have been rejected for chasing shiny objects produced by Big Pharma and funded through Medicaid.
As with most chase events (from fox hunting to faux addiction treatment), attaining the prize is meaningless to the profiteers of the pursuit. In the case of addiction treatment, the money grubbers are a nasty con-artist collection of otherwise unemployable professionals and hawkers of unhelpful, but very expensive, pharmaceutical potions.
Now, the addiction treatment fraudsters have found the perfect pigeon. The pigeon has an identified mission to find an addiction solution (as addiction and recidivism relate), no expertise relating to drug treatment, and an eight-billion-dollar budget. What is even more outrageous (and delicious to the profiteers) is that this particular pigeon, this ignorant patsy, can influence similar pigeons throughout America who have combined budgets that are ten times larger: over eighty billion dollars.
The pigeon is the U.S. Department of Justice Federal Bureau of Prisons (FBOP) and the con is a program that goes by the acronym MAT – Medication Assisted Treatment. Following the FBOP’s lead are state and local prisons throughout the U.S. with budget’s ten-fold of the federal eight billion dollars.
Every federal prison, as per published FBOP policy, is to offer AA to inmates. Most prisons defy that mandate as they sell the flavor of the month promoted by Big Pharma. Today’s flavor is Medication Assisted Treatment (MAT).
Bringing MAT to a prison setting is a match made in hell, except for Big Pharma. The concept supporting MAT (which is lacking any meaningful statistical validation) is that a combination of drugs that will curb/supplant drug craving (usually providing a dull buzz and making the patient a walking zombie) combined with robust participatory programming (picture a group therapy session from an SNL sketch) results in meaningful addiction treatment. Implicit in the concept is that it is unethical and inefficacious to simply administer drugs and give short shrift to programming, but that is the FBOP approach.
Big Pharma makes sure the drugs are bought and administered, but no one asks questions when the programming is a paperwork fantasy or, when meetings do happen, a charade conducted by staff selected so they can receive enhanced pay over qualifications.
The price of the drugs reaches $1400 per dose and the FBOP Health Services organization is militant in assuring every inmate assigned to the MAT program gets their daily dose. Even during the height of COVID lockdowns (inmates confined to their cells 24/7 for months without any programming), MAT participants received a daily “house call” to administer their expensive prescription; the need for supporting program was not seen as important during COVID since the needed MAT programming staff had not been hired.
When the FBOP did manage to hire staff to support MAT, it was not to recruit experienced addiction therapists. MAT programming positions were given as a perk to the right insiders at each prison. Being the spouse or child (sometimes both) of another member of the prison staff was the most consistent data point for filling these new positions along with the position being a raise in pay for those that were already FBOP employees. Almost zero had any previous experience in administering an addiction program, and the active involvement of Health Services (the group administering the drugs) is curiously absent from delivering programming.
The appropriate candidate for MAT is an addict, with a history of attempted recovery and re-lapse, in a free-world setting (i.e., America) where the availability of illegal drugs is plentiful, so without intervention, chances of fatal overdose are statistically significant. The argument is that MAT prevents self-harm that law enforcement (or the addict) is incapable of preventing.
Conversely, the prison junkie is surrounded by low potency high priced drugs where there is, comparatively, limited chances of fatal overdose and the tools of law enforcement, to eliminate drugs, are dramatically greater. Further, the “cold turkey” (withdrawal) risks in a non-incarcerated setting simply do not exist in prison. Finally, a responsible implementation of MAT requires skilled counselors and facilitators that do not exist, nor can they be recruited to work, in a prison setting.
The overwhelming reasons to not implement MAT in prisons can be ignored only where greed of creating a market prevails. Inmates volunteer as one more feint at recovery in the hopes of reducing their sentence. Even if an inmate honestly sought MAT for recovery, the lack of supporting programs makes such a quest ridiculous. It is fake MAT in prison.
Inmates are horrible candidates for MAT, but there are certainly a bunch of them, and prisoners miss fewer appointments (or are more easily located when they do). Sufficient volume overrides ethics. Sales are justification for doing the wrong thing.
The money pit is more important than the solution. Pharma pushes the drug sales while employee unions celebrate the new positions created that are filled as the spoils of membership.
Just another rabbit hole money pit that is a gold mine for fraud …
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