“The general public needs to realize that medicine is a business.”
—Peter Hansen, Ethical Strategies Limited
According to a recent Toronto Sun2 article, the costs of health care services provided within penitentiaries amounted to 150 million dollars in 2008; these included the costs of treatment, methadone, and medication. That amount represents 2.4 times the average health care expenditures of Canadians as a whole, and an 18-million-dollar increase in comparison with the previous year. A few months earlier, other articles published in La Presse3 pointed to medication expenditures averaging $1,900 per inmate, compared to $735 for other Canadians. These articles also pointed to a 50% increase in the cost of medication in Québec prisons between 2002 and 2008.
In a world where everything tends to move quickly, pills seem to have become the solution to all health problems, stress, and insomnia. Doctors are quick to prescribe an abundance of medications, which pharmacists are only too eager to sell, and no one questions our increasing use of prescribed drugs, nor their rising cost. A book by Jean-Claude St-Onge, L’envers de la pilule: les dessous de l’industrie pharmaceutique, puts things in perspective by reminding us that multinational drug companies (and their shareholders) are also seeking to maximize their profits. Profits reaped by the pharmaceutical industry during the 90s were such that even the American Congress rose in protest—the Pfizer Company alone declared sales of 32 billion dollars in 2001.
Of greater concern still, is the fact that much of the budget intended for research and development is used to accelerate the marketing of drugs more than to demonstrate their effectiveness or their safety. According to St-Onge, a 1998 study published in the Journal of the American Medical Association indicates that “106,000 Americans allegedly died after taking medication under normal circumstances, i.e. while strictly adhering to directions. […] That number is nearly double that of Americans who lost their lives in the Vietnam War.”
Fortunately, various alternative treatment approaches have emerged in Québec over the past decades. Thus, the Centre Dollard-Cormier has introduced acupuncture, a 3000-year-old technique, to treat drug addiction. The Elizabeth Fry Society of Québec has developed an innovative program, Agir par l’imaginaire, which provides female inmates with an opportunity to express themselves through the arts, notably photography, video production, and song writing. The Institut Philippe-Pinel now provides pet-facilitated therapy. And the list goes on. While such programs often yield impressive results, many observers remain sceptical, possibly because very little money is invested in research; as a result, their effectiveness can rarely be demonstrated. Also, a great deal of prejudice surrounds alternative approaches that are often perceived as “soft and fuzzy” or esoteric, which might further contribute to their discredit.
Even so, certain initiatives have emerged. The Massachusetts Institute of Technology (MIT) provides mediation workshops intended for its staff and students, who are encouraged to subscribe to these because, among other things, this technique contributes to “lowering blood pressure, increasing concentration and creativity, significantly reducing anxiety and depression, improving self-esteem, in addition to improving the functioning of the immune system and contributing to a feeling of well-being”. Similarly, the Institut de zoothérapie du Québec notes that the use of animals in prison leads to “improved self-esteem in inmates, better relations with other inmates, staff, and their family, as well as reduced violence and a lesser need for medication”5. This could lead us to question CSC’s decision of last December to cancel a dog-training program being offered at the Nova Institution for Women6.
At a time when an ageing population and the privatization of health care are on everyone’s lips, it might be timely to ponder how these approaches could be put to good use.
And while mediation sessions would prove ineffective to treat widespread cancer, it may be time to realize that, often, some individuals’ quality of life could be enhanced through natural and human treatment approaches … all the while, contributing to reduce the financial burden on the community.
1 ST-ONGE, J.-claude. L’envers de la pilule: les dessous de l’industrie pharmaceutique, Montréal, Écosociété, 2004, p. 25.
2 HARRY, Kathleen. « sick inmates costly. Loss of needle-exchange programs behind rising prison care costs, access documents show », Toronto Sun, December 17, 2008.
3 LACOURSIÈRE, ariane. « la consommation de médicaments explose dans les pénitenciers », La Presse, August 13, 2008, and « prisonniers de la pharmacie», July 18, 2008.
4 ST-ONGE, J.-claude, op.cit., page 65.
5 Institut de zoothérapie du Québec, [Online] [www.institutdezootherapie.qc.ca/quebec/spip.php?article13] (visited on September 11, 2009).
6 Le programme Pawsite Direction taught women inmates to treat and train dogs coming from shelters, before turning them over to handicapped persons.
