The Needle and the Damage Done

In prison, getting hepatitis C is easy. Getting treatment isn't.

To become a candidate for drug therapy while in the care of the DOC, a prisoner who's tested positive for hepatitis C must first sign a contract. The contract states that the supplicant will take a year of substance-abuse classes, submit to random urine testing four times during that year, and commit to further tests and classes throughout the course of treatment. It's a straightforward document, one that seems to make perfect sense. After all, a patient who continues to shoot up is probably going to get reinfected anyway, so why bother to offer him a costly and futile program?

"Since you're using expensive and somewhat experimental treatment," says McGarry, "you want to make sure you have a highly motivated group of people who are taking part in this."

Brett Amole
Nancy Brown has battled prison officials over hep C treatment for her husband.
Brett Amole
Nancy Brown has battled prison officials over hep C treatment for her husband.

Yet fulfilling the contract can be a complicated matter. Prisoners aren't very good at following rules -- that's why they're in prison. And the contracts actually involve prohibitions that have little or nothing to do with the medical requirements for successful drug therapy. Consequently, patients who commit what might be considered in another setting a minor infraction -- such as sneaking a cigarette -- could wind up being denied lifesaving medical treatment.

"They're making it a privilege to get interferon," notes inmate Grant Brown, a resident of the Kit Carson Correctional Center in Burlington. "If they think you're a bad boy, you can't get medical treatment, basically."

Brown is a 33-year-old offender serving two consecutive sixteen-year sentences for burglary, courtesy of former Denver judge Lynne "Hang 'em High" Hufnagel. He admits to having dabbled in drugs during his past dozen years behind bars. He also has what prisoners call a "shirt": arms, back and chest covered in tattoos. He was diagnosed with hepatitis C eight years ago. Last spring, while he was staying in a halfway house in Denver, tests showed a dramatic rise in the levels of his liver enzymes, making him a candidate for interferon therapy. But before his own doctor could put him on the drugs, he was yanked out of community corrections for marijuana use and returned to prison.

Since then, Brown has been shuffled from one prison to another, with little attention to his medical problem. One doctor prescribed a low-fat diet that the prison kitchen had trouble accommodating; in the meantime, he's continued to lose weight and battle fatigue and other symptoms. He says he only learned of the requirement that he take a year of substance-abuse classes when he arrived at Kit Carson a few weeks ago; the months of classes he took during his prior prison stay didn't count, he was told, because he'd tested positive for drugs. Brown contended that he ought to get at least some credit for the classes he took at the halfway house -- but then he was told he could be bumped from eligibility because a recent urine test came back positive for a drug that, outside prison walls, is still legal.

"They tell me I'm no longer a candidate for interferon because I had nicotine in my system," Brown says. Although he won't cop to lighting up at Kit Carson, he notes that smoking was permitted at his halfway house, "and I don't know how long a trace of nicotine stays in your system."

Within the DOC, though, nicotine is considered a "substance of abuse" -- and ample reason to deny interferon treatment. "If you're cheating on nicotine, you're cheating on the rules for not using drugs," McGarry explains. "We're given a certain amount of funds to take care of the inmates, and you have to make decisions how you use it. A person who's breaking the rules, I just don't think that's a very good candidate for getting a $25,000 therapy."

Brown contends he's being denied on bureaucratic rather than medical grounds. "I can understand denying you interferon if you're doing dope," he says. "If you're doing heroin or speed or cocaine, you're hammering your liver anyway. But in my case, we're not talking about hard drugs.

"Look, I got this [disease] in prison. Yes, I was doing some illegal activities in prison. Whether I got it from drugs or tattoos, we shall never know. But because I'm in prison, does that make me less of a human being? Because I've gotten some hot UAs [urinalyses], should that be used to deny me treatment? I don't think so. I could teach the classes."

Unlike most prisoners, Brown has an advocate on the outside campaigning for his treatment -- his wife, Nancy, a medical assistant who's cajoled, prodded and browbeaten DOC officials and administrators at Kit Carson, a private prison under contract with the state, concerning her husband's care.

"He's literally dying in there," Nancy Brown says. "I have written. I have called. The warden got mad at me and said, 'You have something to say, you put it in writing.' They won't even talk to me. I've told them I will hold them all responsible if my husband dies because they denied him treatment."

Grant Brown has a parole hearing next summer and expects to be returned to a halfway house long before that. "I will be in community [corrections] before I ever get a biopsy from DOC," he says. "I have almost fourteen years in on a nonviolent property crime. The chances of me getting parole are pretty good. If they don't want to treat me, fine. Release me and let me treat myself."

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