Inside the walls: Exploring the Dynamics of Pharmacy Services in Prison
In my third year of studying pharmacy, an unexpected opportunity arose—a one-day placement at a prison. Until then, my focus within the realm of pharmacy had been predominantly on community and hospital settings. The health and justice sector of pharmacy had never crossed my mind, and I embarked on this placement with curiosity, unaware of the profound impact it would have on my perspective. Surprisingly, this brief immersion illuminated the vital role that pharmacy plays in the intersection of healthcare and justice within correctional facilities.
Within the confines of a prison, the pharmacy stands as a crucial intersection, intertwining healthcare, security, and rehabilitation. The operations within this confined space offer a unique perspective on how medical services are delivered to inmates, balancing safety, accessibility, and treatment. The medical wing serves as a specialized unit for inmates requiring critical medical attention, experiencing mental health crises, or needing protective care. This unit aims to provide immediate and comprehensive healthcare services, staffed with on-call medical professionals available to address urgent needs.
Consultations rooms, which were communal between all healthcare professionals were equipped for all situations. What was interesting is that all the consultation rooms when in use had the doors open along with security guards walking up and down the corridor. This is to ensure visibility and security of both the patients but also the healthcare professionals. This is required but it does result in a loss of privacy to the patient. The main professions included Doctors, Pharmacists and Nurses. However, dentists also have a role in the Health and Justice setting, on call and regular check-ups and usual practice with dentists entering the prison to see the inmates for routine check-ups and emergencies.
Dispensing medications follows strict protocols. This is to prevent misuse or unauthorised distribution. The process is the opposite to most other settings where the patient will come to the nursing area to collect their medications at set times. The set times do pose an issue as when patient require medications at set time or regular intervals which do not correspond to the drug rounds timings of the prison. Medication is passed from the nurses to the patient through the designated open window. Every administration must be observed to ensure compliance. Although all sorts of medications were required ranging from antipsychotics to simple antihistamines, methadone was one of the most important medications. Methadone is a drug which is used to help patients stop taking heroin and reduces withdrawal symptoms such as shaking, shivering and flu like symptoms. As methadone is an opioid it is still addictive, and it’s use needs to be tightly regulated and all administration needs to be observed. What was impressive in the Health and Justice scene is that they had their own methadone dispenser rather than having to measure out the liquid themselves. This ensures 100% accuracy and rules out man made mistakes which is vital for this sort of drug and for this setting.
Pharmacists also have a huge role in the setting in terms of health Education. Pharmacists hold one on one but also group-based discussions with inmates in hopes of improving their health literacy and empower these individuals to take charge of their well-being. The prison I visited was a smoke free prison which means smokers who are in the setting had cravings and needed smoking cessation. This was one of the key pillars of the medical wing with pharmacist undertaking smoking cessation services.
Incarcerated individuals are often engaged in various tasks within the facility, including kitchen and gardening duties. These opportunities serve as way of earning money (albeit small amounts) but also a way to better themselves and make their sentences more enjoyable. Commendable performance in these roles can lead to incentives or reduced sentences, fostering a sense of purpose and achievement in a controlled environment. Families on the outside can also contribute to the well-being of the patients by adding money to their prison bank account. However, the prices of such items are extreme. An example I saw was a small chocolate bar which was £5.
The role of pharmacists within UK prisons is multifaceted, demanding a blend of clinical expertise, adaptability, and a deep understanding of the unique challenges presented by the incarcerated population. Their dedication to providing equitable, quality healthcare contributes significantly to the well-being and rehabilitation of inmates within the justice system.
