OD AT THE DOC

Inmate's Death Highlights The Need For More Drug-Treatment Programs,
Critics Say

Charlene Marquez, 39, had a drug problem. It eventually killed her. But
unlike junkies who overdose in their homes, are killed in drug-related
violence or die of hypothermia on the streets, Marquez died in prison.

She was found dead in her cell early in the morning of Sept. 1, 2002, two
days after her 39th birthday. An autopsy revealed bits of rubber and
plastic in her stomach, the remains of a balloon that had been filled with
heroin.

Her death highlights two serious problems, critics say.

The first is the ease with which illegal drugs are smuggled into prison.
It's a problem common to prisons across the country, one corrections
personnel nationwide struggle to resolve.

But the second has a more local flavor: Colorado's failure to fund
drug-treatment programs adequately inside and outside the prison system.
And it's a problem that is about to grow worse, as the state legislature
makes significant budget cuts in human-services programs in light of the
state's economic woes.

Body of evidence

One of the down sides to death is that you leave your body behind, undefended.

Charlene's body was found in her cell at Denver Women's Correctional
Facility at 6:20 a.m. on Sept. 1. It was photographed, fingerprinted,
placed in a white body bag closed with a locking plastic seal labeled with
the number 0209.

Because Charlene died under suspicious circumstances, her body was quickly
given an autopsy.

The medical examiner measured the length of her long, brown hair: 40 cm. He
examined her genitals and reproductive organs, which were found to be
normal with the exception of a tubal ligation done to prevent pregnancy. He
removed and weighed her brain, heart, lungs, liver, and kidneys. He
catalogued the contents of her stomach and measured the depth of her
subcutaneous abdominal fat.

He noted other things, as well, details of a life now over. Charlene had
blue flowers tattooed on her right thigh. The name "Andy" was tattooed on
the back of her left wrist. There was a large surgery scar on her abdomen.
She was missing several teeth. Her ears were pierced.

It was in her blood that the examiner found what he was looking for.
Toxicology tests revealed a high level of morphine in Charlene's blood and
a small amount of codeine in her bladder. Based on test results, as well as
the bits of rubber found in her stomach, the coroner drew a picture for
investigators that looks something like this:

Late on Aug. 31 or early on Sept. 1, Charlene swallowed a balloon of
heroin. A short time later, the balloon ruptured, flooding Charlene's
system with an overdose of heroin. She died quickly. The body breaks heroin
down into morphine, then codeine. Because her blood levels of morphine were
so high and relatively little codeine was found, she died before her body
could metabolize much of the drug.

"This doesn't look like injection, but rather ingestion," says Dr. Thomas
Henry, who performed the autopsy.

Exactly how Marquez obtained the drug remains uncertain. An internal
investigation continues in the Department of Corrections. Preliminary
information from that investigation is unavailable to the public at this
time for security reasons.

However, a DOC spokeswoman said Charlene had not left the prison, nor had
she received visitors on Aug. 31.

Those facts combined indicate Charlene obtained the drug from a source
within the prison.

Drug economy

Pilot K. Hawkeye Gross used to smuggle drugs into the United States. He
made a lot of money doing it. It finally caught up with the Boulder
resident in 1978, however, when he was arrested with 1,130 pounds of
marijuana. He spent two years in Florida prisons and has since authored
three books on his experiences, including Drug Smuggling: The Forbidden
Book, a how-to guide for people interested in this dangerous but lucrative
career (Paladin Press).

Gross says contraband, particularly cigarettes but also illegal drugs, form
the backbone of the in-prison economy.

"The possibility is much greater of getting contraband into (state prisons)
than at the county level," Gross says.

Prisoners are often taken into the community for work during the day and
can pre-arrange for friends or relatives to drop off banned goods or drugs
in those locations. Gross recalls a lifer who routinely smuggled Smirnoff
vodka into prison using that technique.

"If you can get a bottle of Smirnoff in, you can get anything in," Gross says.

But the primary source of drugs for prisoners in the Florida state system
were prison guards.

"It was a big source of income for them," Gross says. "The guards-that was
their concession."

Most of the guards came from poorly educated, lower-income backgrounds-not
unlike the socioeconomic backgrounds of the prisoners-and were able to
vastly increase their incomes by selling drugs to prisoners.

The most common form of contraband was cigarettes, but marijuana was a
popular second, often sold as tiny $1 "pin joints," Gross says.

He himself traded cigarettes for fresh tomatoes and for a daily change of
clean sheets. While he never saw anyone using heroin in prison, he knew
inmates who used cocaine.

Gross has mixed feelings about the war on drugs. On the one hand, it
presents an opportunity.

"I just love knowing that with my skills and experience, if I decide to
saddle up again, there's a million-dollar payday waiting for me," he says.

On the other hand, it's an enormous waste of money. About $50 billion in
taxpayer money could be saved if the war on drugs ended. If marijuana were
legalized and taxed like tea, Gross estimates another $50 billion would be
generated. The combined $100 billion would be enough to provide free health
care for every American, he says.

Most of all, the war on drugs is pointless, he says. Decades of increased
law enforcement have shown that prohibition does not stop the demand for
drugs nor their illegal importation, yet the effort continues.

"I absolutely guarantee you, I could smuggle in a load of marijuana if I
wanted to," he says. "If there's something you can't stop, what's the point?"

Dope behind bars

"We work our hardest to keep contraband out," says Allison Morgan,
spokeswoman for the Department of Corrections. Still, some drugs make it
inside through a variety of means.

Work crews made up of prisoners who leave the facility are one source, she
says. But correctional officers also play a role.

"Staff bring it in," she says. "I'm not going to run away from that. We
work very hard to prevent that."

Sometimes a staff member will sell drugs for economic reasons, perhaps due
to a personal financial crisis, she says.

Correctional officers in Colorado start at a salary of about $31,000.

At other times, a staff person might find themselves being manipulated by a
prisoner who offers rewards or makes threats in order to obtain certain
contraband. DOC provides intensive training-160 hours of training followed
by year of on-the-job training-to help prepare officers for situations they
might encounter and to prevent guards from being compromised by inmates,
she says.

DOC runs background checks on all its staff, and potential employees are
required to pass a urine test before being hired. Further, random urine
tests are performed throughout the year. But a urine test won't catch an
officer who sells but doesn't use.

"If they don't use it, they're going to come up clean. So hopefully through
intelligence, we'll learn about that," she says.

Each year, 50 percent of Colorado's more than 18,000 prisoners are randomly
tested for drug use through urinalysis. About 3 percent of the population
tests positive, a figure which is "very low," she says. If testing reveals
clusters of positive results, officials launch an investigation, which can
include searches, more urine testing and surveillance. Oftentimes, inmates
themselves will step forward with information, and their identities are
protected. Colorado DOC does not make use of undercover officers, she says.

In addition, DOC records all inmate phone calls, except those to attorneys,
which are protected by law. Inmates are warned when they enter prison that
their conversations will be monitored.

"It's still amazing what they say in those conversations," Morgan says.

But the biggest risk to security in Colorado's prisons are visitors, she
says. Last year, the East Canyon City complex received more than 55,000
visitors. While maximum security inmates are not allowed contact visits
with friends and family, other inmates are allowed to be in the same room
with their visitors. They are strip searched afterwards, but some manage to
conceal contraband inside their bodies, either swallowing them or inserting
them in a body cavity. Body-cavity searches require a search warrant and
probable cause and are therefore not performed routinely.

If urine tests show clusters of positive results in certain units,
authorities might run a drug interdiction, searching the cars and personal
possessions of visitors and making ion scans of their clothes and hands.

"We recently had a grandma who was bringing it in," Morgan says.

Supply and demand

While corrections officials and law enforcement work to contain the supply
of drugs, prisoner-rights advocates and drug-treatment practitioners say
the state would do well to look equally at the demand. Colorado ranks dead
last in state dollars spent in drug treatment. (The state is officially
listed as 49th because Georgia state officials neglected to turn data in on
time. However, had Georgia turned information in on time, Colorado would
rank 50th.)

Research shows that for every $100 Colorado spends on the consequences of
drug and alcohol abuse, only 6 cents are spent on treatment programs, says
Janet Wood, director of the Alcohol and Drug Abuse division of the Colorado
Department of Human Services.

That investment is about to drop as state budget problem, exacerbated by a
sluggish economy, have resulted in budget cuts in drug-treatment programs,
both in the prison system and outside. The DOC is expected to lose almost
$270,000 of its $6.3 million drug and alcohol treatment budget. Additional
funds will be cut from parole and community corrections programs that
provide essential follow-up treatment to help addicted inmates adjust to
living outside an institution.

In Colorado, all inmates entering state prisons are evaluated for physical,
mental health and drug and alcohol problems. Those needing no drug or
alcohol intervention are designated as Treatment Level 1. Those with
extreme needs are classified as Level 6.

About 75 percent of all DOC inmates have some level of drug or alcohol
problem, Morgan says.

But not all of those inmates have their needs met. A report published in
December 2001, shows significant gaps between treatment needs of DOC
inmates and available treatment services, particularly for levels 3, 4 and
6. (Level 5 treatment is not available within the system.)

For female inmates, no Level 2 treatment is available. About 37 percent of
female inmates in need of Level 4 treatment don't receive it, while a
staggering 64 percent of women in need of the highest level of intervention
don't receive needed services.

At Denver Women's Correctional Facility, where Charlene was incarcerated,
there is a rare Level 6 program-a therapeutic community-as well as two
Alcoholics Anonymous groups. There are no level 2, 3 or 4 programs
available at the facility.

However, state law prevents DOC officials from revealing whether Charlene
was receiving assistance through either program. Her needs, like those of
other female inmates, may have been more acute than those of the average
male inmate. Research shows that most women in prison are victims of
substantial physical and/or sexual abuse and have deep-seated emotional
needs, Morgan says. DOC research shows that women who do have drug and
alcohol problems typically need higher levels of treatment than male prisoners.

"That was one of the reasons we built Denver Women's," Morgan says. "I wish
we could have a therapeutic community in every prison, but it's not
financially realistic, so we try to prioritize."

The impact of prison

But some say prison is not conducive to recovery from addiction and that
institutional drug-treatment programs face significant obstacles to success.

"Prison is not a therapeutic environment," says Christie Donner,
co-coordinator of the Colorado Criminal Justice Reform Coalition, a project
of the Rocky Mountain Peace and Justice Center.

The coalition works with current and former inmates on a host of issues
ranging from parenting while in prison to navigating the prison system to
parole problems. The coalition also works to promote legislation that would
reduce drug sentences and increase access to effective drug-treatment
programs. Last year, the organization played a crucial role in the passage
of the asset forfeiture bill, which requires a person be convicted of a
crime before law enforcement can seize property or other assets.

Donner says less than half of prisoners who need help with drug and alcohol
problems receive it. Most receive it shortly before their release date,
after they've already become hardened from exposure to prison culture.

"People get warehoused for years, and when they get close to being released
is when they're eligible for treatment," Donner says. "This notion that
everyone who needs treatment gets it is not the truth. It's a very small
percentage that are actually offered treatment."

Those who receive treatment often have a difficult time trusting therapists
and prison staff, as their conversations are not confidential.

"People are afraid whatever they say can and will be used against them in a
court of law, and it can be," Donner says. "It's not a safe environment,
and I think that's a prerequisite for effective treatment."

Further, prison tends to have an impact on inmates' emotional well-being,
giving them a tendency to shut down rather than open up. Even if they try
to address their problems behind bars, the controlled prison environment is
a sharp contrast to the world they meet when they're released.

"It's not a real-world environment," Donner says. "If we assumed prisons
were a drug-free environment-which they obviously are not with the death of
Ms. Marquez-forced abstinence is not the same thing as recovery."

Inmates must learn to cope with the challenges of life without drugs or
alcohol. But that's much easier said than done. The world people leave
behind when they're sentenced is often not the world they meet when they're
released. About 90 percent of married inmates face divorce, many the loss
of their children. If they have a felony record, they'll find it very
difficult to find work or housing. In addition, housing and educational
loans available to others are not available to them, putting limitations on
opportunities to improve themselves and their financial well-being.

"Unless people can access treatment on the outside as part of their
recovery, their likelihood of succeeding is very small," Donner says. "I
think we as a society don't appreciate the impact prison has on people."

Wood says prison treatment can be effective-under certain circumstances.

"There has been research on institutional treatment programs, but what the
research shows is it has to be followed by aftercare in the community,"
Wood says.

Inmates who receive aftercare have a decent chance of repairing their
lives, but those receiving treatment in prison and no aftercare exhibit the
same kinds of behaviors and problems within 18 months of their release as
those who received no treatment, she says.

"The reality is, in working with people who are trying to reintegrate,
unless you have family or a support system, you're not going to make it,"
Donner says.

Society's failures

Charlene was incarcerated on a four-year sentence in May 2000. She was
released into community corrections-a halfway house-by September. A year
later, she was allowed to live on her own under intense supervision.

But on March 13, 2002, she was returned to prison for a disciplinary
infraction, Morgan says.

Within six months, she was dead.

Did the Colorado correctional system fail Charlene Marquez?

"She's dead," Donner says. "How much more of a failure can there be? Part
of the responsibility is hers, but part of the responsibility is ours. I
wouldn't put all the responsibility on her shoulders because we could be
doing things that are proven more effective."

The key to treating drug and alcohol problems effectively is to acknowledge
them as medical and mental health problems, she says. Colorado places too
much emphasis on punishment and the criminal aspect of addiction and far
too little on effective treatment.

The funding situation is so bad in Colorado with regard to both drug
treatment and mental health treatment that it should be considered a
crisis, Donner says.

"The stick is bigger than the carrot," she says. "People with substance
abuse problems are risking death. If that's not a deterrent, prison won't be."

Not only can drug addiction itself land a person in prison, but the normal
recovery process, which includes relapses, is a criminal offense. People
trying to work their way free of addiction find themselves in and out of
prison and develop a sense of failure, Donner says.

"The criminal justice system just looks at what this person did on this
day, and if they're guilty, they punish them," she says. "There are so many
gaps in the social infrastructure."

Last year's legislative attempt to reduce some drug sentences and put that
money toward treatment passed both houses of the state legislature but was
vetoed by Governor Bill Owens, who has repeatedly voiced his opposition to
shortening drug sentences-and his mistrust of drug-treatment programs.

"You lock people up in a cage in Canyon City and say the problem is
solved," she says. "But it's not. The prison system becomes the dumping
ground for all the areas where society is failing."

Where does Charlene fall into the picture?

"The bottom line is she's dead. She's just another victim of the drug war,"
Donner says. "The question that comes to mind is, 'Would Ms. Marquez be
dead if she'd been in an inpatient treatment center instead of prison?'"