Take a look inside and learn about the State of Indiana Forensic & Health Science Laboratories' drug unit lab. Kelly Wilkinson/IndyStar
More than 8,000 doses of a frequently abused pain medication are missing from an Indiana prison.
Officials at New Castle Correctional Facility discovered 8,114 missing doses of gabapentin last month. The medication is used to treat nerve pain and seizures, but is often abused in prisons and, increasingly, in the outside world.
The missing drugs raise concerns about security and prescription practices in Indiana’s prisons, where a new private company recently took over medical and pharmacy services for the state’s 26,000 prisoners under a $309 million, three-year contract.
The Indiana Department of Correction is investigating the matter, but exactly how such a large quantity of medication went missing remains unclear.
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Isaac Randolph, an IDOC spokesman, initially said several offenders "MacGyvered" a locked cage and were able to steal "several blister packs" of medication sometime around Dec. 14.
He later acknowledged that more than 8,000 doses went missing over the course of two months and said the problem was only discovered in mid-December. He declined to say if suspects have been identified or if any of the medication has been recovered, citing the ongoing nature of the investigation.
"We have since changed the location of the medication now behind a locked door on site and our Intelligence and Investigation team are finishing up their investigation," he said.
The disappearance of a widely abused drug is especially concerning given that the state’s new contract with Pittsburgh-based Wexford Health Sources was touted as an important step in combatting Indiana’s drug abuse epidemic, a top priority for Gov. Eric Holcomb.
IDOC Commissioner Rob Carter has highlighted Wexford’s “focus on attacking the drug epidemic” and praised the company for its “expertise and experience around the nation addressing these issues.”
A spokeswoman for Wexford did not return phone and email messages seeking comment for this story.
Although gabapentin is not an opioid and is not designated a controlled substance by federal authorities, it can boost the high caused by narcotics, ward off drug withdrawals and block the effects of medication used for addiction treatment, allowing patients to get high while in recovery.
As a result, it is a well-known risk in prison environments. In fact, Wexford highlighted that risk in a Dec. 18 document outlining the appropriate use of gabapentin.
“This drug is highly abused in the drug restricted prison environment,” the company said. "Abuse by prescribed recipients, and related trafficking makes the drug a highly valuable commodity, giving every individual prescribed this drug automatic exposure to these incentives and risks.”
Because of those risks, gabapentin should be treated like a controlled substance, said Ronald Shansky, a physician and expert on correctional medical care.
That means the medication should have been under double lock and key, preventing offenders from even accessing the area where the drugs were kept, he said. And doses of the medication should be meticulously tracked at the beginning and end of every shift, preventing such a large quantity of drugs from disappearing over the course of months.
Shansky said he also has concerns about the amount of gabapentin being prescribed at New Castle.
About 175 to 215 of the New Castle facility's 3,155 prisoners are prescribed gabapentin, according to IDOC. Those prescriptions resulted in shipments of more than 38,300 doses during the two-month period of October and November.
“That seems like an excessive amount," said Shansky, a former medical director for the Illinois prison system who has served as a consultant and court-appointed monitor for jail and prison systems across the country.
He said that in most cases, there are better treatment alternatives to gabapentin, also known by the brand name Neurontin.
Prisons aren’t the only place where gabapentin is being abused. Increasingly, abuse is popping up in the general population as well.
A spike in abuse prompted Ohio authorities to issue an alert in February warning that gabapentin is "widely sought for illicit use." Kentucky became the first state to designate gabapentin a controlled substance under state law in July. And the West Virginia pharmacy board last month declared the medication a "drug of concern" after overdose deaths involving gabapentin jumped from 36 in 2012 to 106 in 2016.
The severity of the problem in Indiana, however, is less clear. The State Department of Health does not track overdose deaths from gabapentin and a spokeswoman said she wasn't aware of any other agency that tracked that information in Indiana.
Call IndyStar reporter Tony Cook at (317) 444-6081. Follow him on Twitter and Facebook.