Sustiva “Dirty Drops”
Put Prisoners in Solitary
by Enid Vázquez
Inmate Efrain Campbell
was eagerly looking forward to finishing his six months in
solitary confinement following a fight at Illinois’ Pontiac
Correction Center (PCC). But then his drug tests kept coming
back positive. He was accused of smoking marijuana and it
was determined that he should be held another six months in
solitary. At the same time, prisoner advocates learned that
more than a dozen other prisoners at three different Illinois
prisons were found to have “dirty drops” for marijuana, and
were being punished by being put in solitary confinement or
losing months of good time (which would have reduced their
prison sentence). One inmate lost six months of good time
and six months of contact visits. Like Campbell, each prisoner
was HIV-positive, and each was taking the anti-HIV drug Sustiva
(efavirenz).
Sustiva is known to make
people wrongly test positive for marijuana use (called “false
positive” results). But here the story gets tricky, and the
crisis for the prisoners builds. (Remember when you see the
word “assay” that it means a test.)
The Sustiva package insert
is ambiguous: “False positive test results have only been
observed with the CEDIA DAU Multi-Level THC assay, which is
used for screening, and have not been observed with other
cannabinoid assays tested, including tests used for confirmation
of results.” That makes it sound like Sustiva manufacturer
DuPont Pharmaceuticals tested the med against all marijuana
tests. In fact, the company did not do so, and it did not
look at the test used in Illinois prisons, DrugCheck 5. DuPont
only looked at three marijuana assays. The other two tests
measured were Cannabinoid Enzyme Immunoassay from Diagnostic
Reagents and AxSYM Cannabinoid assay from Abbott Laboratories.
This helps get the Illinois
Department of Corrections off the hook for civil rights violations.
In a letter to a prisoner advocate group, IDOC Deputy Chief
of Institution Operations Larry Sims wrote that, “The Department
is currently unaware of any scientific evidence to suggest
that the DrugCheck 5 reacts to Sustiva by rendering a false
positive. Research conducted by DuPont reflects that only
the [CEDIA DAU] assay has been identified as creating false
positives. Other assays do not cause false positives. The
Department will continue to monitor this situation in an attempt
to determine if a further investigation is warranted.” But
advocates say IDOC has done nothing.
In the midst of the Illinois
crisis, the purchase of DuPont by Bristol-Myers Squibb was
finalized on September 26. That left DuPont staff scrabbling,
and allegedly unable to run lab tests to see how the Illinois
marijuana test functions with Sustiva. But David Rosen, associate
director of public affairs for DuPont Pharmaceuticals, said
that the DrugCheck 5 package insert clearly states that a
confirmatory test must be used and that it is up to IDOC to
run those tests. He notes that even the CEDIA DAU test states
that a confirmatory test must be given following positive
results. The package insert for both tests states that, “The
test provides only preliminary data which should be confirmed
by other methods such as gas chromatography/mass spectrometry
(GC/MS). Clinical consideration and professional judgment
should be applied to any drug of abuse test result particularly
when preliminary positive results are used.” Rosen also said
it is up to the DrugCheck 5 manufacturer to test Sustiva for
interactions. He said DuPont will look into changing the wording
of its package insert, which requires approval by the Food
and Drug Administration (FDA), and that such a change might
be able to go into effect immediately.
In memos, prison healthcare
providers reported simply that, “We have been directed from
Office of Health Services that positive drug screens are a
security issue, and we are not to get involved” and “Per the
Office of Health Services, we can confirm for security you
are on the medication but whether it causes false positive
is not a medical issue.” [Emphasis in the original.]
In a letter to IDOC director
Donald N. Snyder, Jr., Charles A. Fasano, staff associate
at the John Howard Association (a prison reform organization
located in Chicago), explained that, “If use of a prescribed
medication such as Sustiva, which is essential in AIDS treatment
[as they are all], caused any false positive test results,
inmates will be placed in a position of having to choose between
punishment in segregation and prolonging their lives with
a medication that leads to their placement in segregation.”
He adds that prisoners refuse to continue taking their Sustiva,
“for fear that they will fail further random urine tests.”
Prisoner advocate Dick Helms,
also at the John Howard Association, says, “How can all of
these people be flunking the test? That’s too much of a coincidence.”
Prisoners taking Sustiva can contact Helms at the association,
300 W. Adams, Chicago, IL 60606, or Jackie Walker, National
Prison Project, American Civil Liberties Union (ACLU), 733
15th St. NW, Suite 620, Washington, DC 20005. In the meantime,
it is obvious that prisoners and others, such as people on
methadone, need to reconsider going on Sustiva.
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