The Norfolk City Jail psychiatrist resigned last week amid what he described as rampant prescription drug abuse fueled by over-distribution of drugs to inmates.
Dr. Matthew Sachs, a contractor for the prison’s third-party healthcare provider, Wellpath, resigned on April 29 after six months on the job.
Before Sachs became the prison contractor, more than a third of the prison population was medicated, according to emails between Sachs and Wellpath. But during his brief stint, Sachs nearly halved the number of inmates on medication. When they complained, Sachs said the sheriff’s office responded by demanding he dramatically speed up his weekly consultations with inmates — a signal to Sachs that the jail wanted him to hand out prescriptions at the previous rate.
In an interview this week, Sachs said the sheriff’s office had demanded he start meeting a quota that, essentially, would require inmates’ psychiatric appointments to be under 10 minutes. At that length, he said, the sessions would violate psychiatric standards by not allowing enough time for an accurate diagnosis or to determine what medications were needed.
“It was so outside the standard of care in the mental health field,” Sachs told The Pilot. “It was unethical and dangerous.”
The Norfolk Sheriff’s Office has denied making requests to Sachs for more psychiatric appointments for inmates, although Sachs has a recording of a conversation with a senior prison official that contradicts the denial. The sheriff’s office declined to answer additional questions from The Pilot.
The former prison psychiatrist could not be reached for comment.
Sachs, 42, who runs a private practice in Virginia Beach, said he took the job at Norfolk Jail because he wanted to help underserved people. It was contract work, nine hours a week, managed by Wellpath.
Sachs holds postgraduate degrees from Harvard University, Virginia Commonwealth University, and the University of Massachusetts-Amherst.
After starting in prison in November, Sachs discovered what he described as “a huge problem” with prescription drug abuse.
At the time, more than 300 patients were taking psychiatric drugs, according to emails. By comparison, the prison had an average of 784 inmates between October and April, according to Jamie Bastas, a prison spokesman.
The most commonly taken medications were prescription antidepressants, anti-anxiety medications and antipsychotics, Sachs said.
The antipsychotic drug Zyprexa, the antidepressant Remeron and the anxiety drug Buspar had been “prescribed at very high rates” by the former psychiatrist, Sachs told the sheriff’s office in a Sept. 7 email. december.
He said nurses and guards alerted him “constantly” that inmates were caught hoarding, crushing and misusing their prescribed drugs – drugs he said produce “a huge high ” if they are snorted or ingested in large doses.
Sachs appears to have sharply reduced the number of psychiatric drugs prescribed to inmates during his first four months on the job. By being stricter on medication, the number of inmates taking psychiatric drugs fell to 187 in February, according to the emails.
“The nurses are happy,” but the “inmates hate it,” Melissa Peppenhorst, Sachs’ supervisor at Wellpath, wrote to him in an email. The former prison psychiatrist “conditioned everyone to expect Buspar, Atarax, Hydroxyzine and Remeron to treat sleep and anxiety”.
In the same email, Peppenhorst also said some prison staff did not understand why inmates who felt anxious “can’t have something to calm them down.”
“Prison is hard, I understand that, but I can’t heal the whole prison,” Sachs replied.
Sachs’ approach sparked “an influx of complaints” from inmates and their families, according to emails between Sachs and Peppenhorst.
“The biggest complaint from family members is that patients aren’t getting the medicine they’re used to when they’re at (Norfolk City Jail),” Peppenhorst told Sachs in an email. April 21 email.
The prison guards, according to Sachs, cared about one thing mainly: they wanted the complaints to go away.
Through Wellpath, the sheriff’s office demanded, with little explanation, that he more than double his weekly appointments, Sachs said.
Peppenhorst told Sachs in a Feb. 21 email that the sheriff’s office wanted him to see a minimum of 50 inmates per week during the nine hours he was hired. So far, Sachs said he’s seen between 15 and 20 patients a week.
Peppenhorst told Sachs in the email that the office’s desire for more appointments was based on the schedule of the former prison psychiatrist, who saw between 50 and 60 patients a week, a she declared.
The sheriff’s office “said their expectation was 50 per week on that basis,” Peppenhorst said.
Although the sheriff’s office denied requesting an increase in psychiatric appointments, Sachs secretly taped an April 28 conversation with the sheriff’s office chief of staff, Wayne Handley. The pilot provided the recording to the sheriff’s office, who did not dispute that Handley was the staff member on the tape.
During the meeting, Sachs told Handley that the quota could put inmates’ lives at risk and would be a liability for himself and the prison.
“You want me to go fast. But I won’t at the risk of a misdiagnosis,” Sachs said. “It will lead to malpractice.”
Handley ended the meeting by telling Sachs, “From the perspective of the (Norfolk Sheriff’s Office), I need to see more patients. The complaints have to stop.
Sachs said he interpreted that request to mean that Handley wanted him to give the inmates the orders they were asking for to end the complaints..
Sachs submitted his resignation to Wellpath via email a day later.
“Options to continue working under the same conditions, which the Chief has confirmed, would have had dire consequences for me, and possibly Norfolk City Jail,” Sachs said in the email. .
Sachs provided a handful of emails and prison incident reports that detail instances in which inmates were caught hoarding, abusing or selling prescription drugs in prison.
For example, on March 1, prison staff wrote that they had found “crushed” Buspar, an anxiolytic, hidden in a sock in an inmate’s cell. According to the report, the inmate was prescribed the drug twice a day. They estimated that the amount of crushed Buspar found in his cell was equivalent to about five days worth of his medication.
In an email, a prison mental health worker asked Sachs to discontinue an inmate’s prescription of Zyprexa, the antipsychotic used to treat schizophrenia, after receiving complaints that she had “accumulated and shared his Zyprexa with other inmates” and “crushed it”. ”
Sachs told the Pilot that these incidents were “just the tip of the iceberg.”
Daniel Berty, firstname.lastname@example.org