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United Way of Lancaster County


Advocate calls on County Prison to discontinue handcuffing participants in MAT drug program

Lancaster County Prison. (Photo: Tim Stuhldreher)

Handcuffing County Prison inmates while they ingest medication for substance use disorder is keeping them from diverting it as contraband and is not inhumane, prison officials said Thursday.

Gail Groves Scott

They were responding to local drug policy researcher and advocate Gail Groves Scott, who challenged the practice sharply at the Prison Board’s monthly meeting.

Cuffing or “shackling” individuals in a voluntary treatment program is highly unusual, she said, saying she contacted other researchers in the field and none of them had heard of anything similar. It is not an evidence-based practice, she said, it’s counterproductive and potentially discriminatory under the Americans With Disabilities Act.

“I hope that we discontinue this protocol,” she said.

The County Prison launched its medication assisted treatment program, or MAT, in September 2022. Eligible inmates receive buprenorphine, which can mitigate the symptoms of withdrawal.

Until this month, the prison’s program was limited to continuing MAT for inmates who began it elsewhere. Starting in April, it began “inductions,” or initiating medication for new patients, Deputy Wardin Joe Shiffer said.

There have been 14 inductions since April 1, he said. There are 72 individuals “on the line” for MAT currently, he said, and 91 participants since Jan. 1.

The prison tried several other approaches to prevent diversion, he said: It initially had inmates sit on their hands during medication administration; then it had them wear a smock similar to a barbershop cape. Neither was effective, but handcuffing has brought diversion under control.

“That’s how we got to where we are,” Shiffer said.

The prison had to figure out for itself what worked, Warden Cheryl Steberger said: “There was not a rule book.” Security is paramount, she said.

The handcuffing process is handled professionally and humanely, the warden and deputy warden said. Responding to a question from Scott, Steberger said the prison does not handcuff pregnant women.

Commissioner Josh Parsons said he’s open to discussing best practices, but not to second-guessing the decisions of Steberger and her team.

“I’m not going to dictate security procedures to the people who have to live it every day,” he said.

Shiffer said the prison looked at other correctional institutions as it developed its approach, and that they employ similar practices. Scott reiterated that she’s not aware of any, and that research studies and guidelines on MAT in correctional settings do not mention handcuffing as an option. She provided a list of those resources to county and prison officials, along with a memo outlining her concerns. Both documents are posted (here and here) on the website of her organization, the Health Policy Network.

As more inmates enter MAT, diversion may decrease, Shiffer said. The prison is continuously reviewing its practices and is open to change if appropriate, he said.