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Death Behind Bars 

Inmate's death highlights the need for more drug-treatment programs

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 common problem 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 downsides to death is that you leave your body behind, undefended.

Marquez'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 she 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 cataloged 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. Marquez 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 her 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, Marquez swallowed a balloon of heroin. A short time later, the balloon ruptured, flooding her 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," said 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 Marquez had not left the prison, nor had she received visitors on Aug. 31. Those facts combined indicate she obtained the drug from a source within the prison.

The forbidden book

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 and pilot 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 said. 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 said. 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 said. "The guards -- that was their concession."

Most of them 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 country's continuing 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 said.

On the other hand, it's an enormous waste of money, he notes. About $50 billion in taxpayer money could be saved if the war on drugs ended. If marijuana were legalized and taxed like beer, 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 said. "If there's something you can't stop, what's the point?"

Bringing it in

"We work our hardest to keep contraband out," said 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. Correctional officers also play a role.

"Staff bring it in," she noted. "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, for example, start at a salary of about $31,000 in Colorado.)

At other times, staff persons might find themselves being manipulated by a prisoner who offers rewards or makes threats in order to obtain certain contraband.

The DOC provides intensive training -- 160 hours followed by a 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 also runs background checks on all 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 said.

The Colorado DOC does not make use of undercover officers, she says. However, 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 that 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.

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 said.

But the biggest risk to security in Colorado's prisons is visitors, she says. Last year, the DOC's prison complex in Cañon City, 40 miles southwest of Colorado Springs, 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 afterward, but some manage to conceal contraband inside their bodies, either swallowing them or inserting them into 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 said.

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 currently 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 problems, exacerbated by a sluggish economy, have resulted in budget cuts in drug-treatment programs, both in the prison system and outside.

This year, the DOC is expected to lose almost $270,000 of its $6.3 million drug and alcohol treatment budget. Additional funds are expected to 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. According to the report, 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 Marquez 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 Marquez 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 said. "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," said 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 issues ranging from parenting while in prison to navigating the prison system to parole problems, and also works to promote legislation that would reduce drug sentences and increase access to effective drug-treatment programs. Last year, it 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," she said. "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 said. "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 inmates 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 said. "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 said. "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 said.

"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 said.

Society's failures

Charlene Marquez 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 Marquez?

"She's dead," Donner said. "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.

However, 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 Gov. 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 Cañon City and say the problem is solved," Donner said. "But it's not. The prison system becomes the dumping ground for all the areas where society is failing."

Population explosion

Colorado's current prison population: 18,000
Number of facilities: 27
Average of new prisoners per month: 100
Cost to taxpayers per prisoner per day: $65
Between 1996 and 2000, the population grew: 37%
Cost to taxpayers of proposed new Canon City high-security prison: $80,000,000

Source: the Colorado Department of Corrections

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