Judge Allows Vocational Nurses to Administer Naloxone in Prisons

By Paul Gaita 03/17/17

The waiving of a California law now allows LVNs to administer naloxone without a doctor's permission.

A nurse helping an inmate.
Photo via YouTube

In an effort to stem the tide of overdose deaths among inmates, a federal judge has waived a California state law that prevents licensed vocational nurses (LVNs) from administering the opioid overdose antagonist drug, naloxone, without permission from a doctor.

The waiver was requested by California Correctional Health Care Services federal receiver J. Clark Kelso, a law professor and associate dean of strategic initiatives at the University of the Pacific's McGeorge School of Law. As the receiver, Kelso facilitates the health care system for inmates in the California Department of Corrections and Rehabilitation at the behest of federal judge Thelton Henderson of California's Northern District.

In making his request, Kelso presented statistics that show drug overdoses are among the leading causes of death in the state's prison system, and continues to rise each year. When administered, naloxone can reverse respiratory failure from opioid overdose, but California law allows only registered nurses to use the drug without a doctor's approval.

"Precious time can be lost and unnecessary injury, and even death, may result," wrote Kelso in his request, adding that the climbing death rate would not allow for state lawmakers to change the law.  

Both the state and the non-profit Prison Law Office agreed with Kelso's request, which was subsequently approved by Judge Henderson. Henderson took control of the California prison healthcare system in 2005 after finding that prisoners' rights had been violated under the Eighth Amendment to the U.S. Constitution, which prevents the federal government from imposing cruel and unusual punishment.

Upon finding that too many inmates were dying from neglect and malpractice, Henderson appointed Robert Sillen as receiver in 2006, who was replaced by Kelso in 2008 to carry out improvements to the system.  

California's prison system employs approximately 2,000 registered nurses and 1,800 licensed vocational nurses, whom Kelso spokesperson Joyce Hayhoe described as "predominantly our first responders for health care services in the prison system. The LVNs really function as our EMTs and paramedics in the prison system, so that's why we needed them to be able to administer these lifesaving drugs."

The move is the latest improvement to the California state prison health care system initiated by Kelso and Henderson; in January 2017, health care at San Quentin State Prison, the oldest correctional facility in California, became the tenth of the state's 34 prisons to be turned over to the Department of Corrections and Rehabilitation to oversee the health of its inmates.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.