by Amy Goldstein & Dana Priest, Washington Post, 14 May 2008
Immigrants sedated without medical reason
The U.S. government has injected hundreds of foreigners it has deported with dangerous psychotropic drugs against their will to keep them sedated during the trip back to their home country, according to medical records, internal documents and interviews with people who have been drugged.
The government’s forced use of antipsychotic drugs, in people who have no history of mental illness, includes dozens of cases in which the “pre-flight cocktail,” as a document calls it, had such a potent effect that federal guards needed a wheelchair to move the slumped deportee onto an airplane.
“Unsteady gait. Fell onto tarmac,” says a medical note on the deportation of a 38-year-old woman to Costa Rica in late spring 2005. Another detainee was “dragged down the aisle in handcuffs, semi-comatose,” according to an airline crew member’s written account. Repeatedly, documents describe immigration guards “taking down” a reluctant deportee to be tranquilized before heading to an airport.
In a Chicago holding cell early one evening in February 2006, five guards piled on top of a 49-year-old man who was angry he was going back to Ecuador, according to a nurse’s account in his deportation file. As they pinned him down so the nurse could punch a needle through his coveralls into his right buttock, one officer stood over him menacingly and taunted, “Nighty-night.”
Such episodes are among more than 250 cases The Washington Post has identified in which the government has, without medical reason, given drugs meant to treat serious psychiatric disorders to people it has shipped out of the United States since 2003 — the year the Bush administration handed the job of deportation to the Department of Homeland Security’s new Immigration and Customs Enforcement agency, known as ICE.
Involuntary chemical restraint of detainees, unless there is a medical justification, is a violation of some international human rights codes. The practice is banned by several countries where, confidential documents make clear, U.S. escorts have been unable to inject deportees with extra doses of drugs during layovers en route to faraway places.
Federal officials have seldom acknowledged publicly that they sedate people for deportation. The few times officials have spoken of the practice, they have understated it, portraying sedation as rare and “an act of last resort.” Neither is true, records and interviews indicate.
Records show that the government has routinely ignored its own rules, which allow deportees to be sedated only if they have a mental illness requiring the drugs, or if they are so aggressive that they imperil themselves or people around them.
Stung by lawsuits over two sedation cases, the agency changed its policy in June to require a court order before drugging any deportee for behavioral rather than psychiatric reasons. In at least one instance identified by The Post, the agency appears not to have followed those rules.
In the five years since its creation, ICE has stepped up arrests and removals of foreigners who are in the country illegally, have been turned down for asylum or have been convicted of a crime in the past.
If the government wants a detainee to be sedated, a deportation officer asks for permission for a medical escort from the aviation medicine branch of the Division of Immigration Health Services (DIHS), the agency responsible for medical care for people in immigration custody. A mental health official in aviation medicine is supposed to assess the detainee’s medical records, although some deportees’ records contain no evidence of that happening. If the sedatives are approved, a U.S. public health nurse is assigned as the medical escort and given prescriptions for the drugs.
After injecting the sedatives, the nurse travels with the deportee and immigration guards to their destination, usually giving more doses along the way. To recruit medical escorts, the government has sought to glamorize this work. “Do you ever dream of escaping to exotic, exciting locations?” said an item in an agency newsletter. “Want to get away from the office but are strapped for cash? Make your dreams come true by signing up as a Medical Escort for DIHS!”
The nurses are required to fill out step-by-step medical logs for each trip. Hundreds of logs for the past five years, obtained by The Post, chronicle in vivid detail deviations from the government’s sedation rules.
An analysis by The Post of the known sedations during fiscal 2007, ending last October, found that 67 people who got medical escorts had no documented psychiatric reason. Of the 67, psychiatric drugs were given to 53, 48 of whom had no documented history of violence, though some had managed to thwart an earlier attempt to deport them. These figures do not include two detainees who immigration officials said were given sedatives for behavioral rather than psychiatric reasons before being deported on group charter flights, which are often used to return people to Mexico and Central America.
Even some people who had been violent in the past proved peaceful the day they were sent home. “Dt calm at this time,” says the first entry, using shorthand for “detainee,” in the log for the January 2007 deportation of Yousif Nageib to his native Sudan. In requesting drugs for his deportation, an immigration officer had noted that Nageib, 40, had once fled to Canada to avoid an assault charge and had helped instigate a detainee uprising while in custody. But on the morning of his departure, the log says, he “is handcuffed and states he will do what we say.” Still, he was injected in his right buttock with a three-drug cocktail.
In one printout of Nageib’s medical log, next to the entry saying he was calm, is a handwritten asterisk. It was put there by Timothy T. Shack, then medical director of the immigration health division, as he reviewed last year’s sedation cases. Next to the asterisk, in his neat, looping handwriting, Shack placed a single word: “Problem.”