1. On April 19, 2013, two representatives of APADOR-CH went to the General Police Direction custody facility to check information about the physical and mental state of detainee Ninel Viorel Onţică, a former drug addict who had been under methadone treatment for more than 10 years (methadone is a legal substitute). The substitute was administered by CAIA (Center for Integrated Assistance for Addictions) Obregia, which is subordinated to the National Anti-Drug Agency (ANA), under the authority of the Ministry of Interior. The same Ministry co-ordinates the activities of the General Police Inspectorate of Romania (IGPR). In other words, ANA and IGPR are mates – they work under the same umbrella and should follow the same rules. But while ANA and its subordinated branch CAIA offer substitute treatment to all addicts who wish to quit drugs, IGPR obstinately refuses treatment for detainees under its custody. Until 2-3 years ago, the police openly opposed methadone treatment in custody facilities, arguing that “abstinence is the best cure”. The answer provided by the IGPR to a report written by APADOR-CH following visiting the same facility on November 2, 2011, indicates that their attitude has changed in the meanwhile, at least on paper.
The answer, dated January 30 2012, includes clarification by the Medical Direction of the MoI, which had “already taken steps … to prepare regulation standards for medical assistance in centers for preventive arrest and detention, including assistance for drug users (our highlight); also, consultations were launched for… the continuation of substitution treatment for drug users who have already started this course of treatment (our highlight) before being taken into custody”. Unfortunately, 15 months later, the “steps taken” and “consultations launched” failed to materialize in any concrete results, and the police still categorically opposes the continuation of treatment in custody. This time, their arguments center round the lack of “procedures” for custody facility medical cabinets to receive and distribute the substance to people already undergoing treatment.
2. The legal situation of detainee Ninel Viorel Onţică raises a problem. Onţică was convicted for two counts, theft and drug dealing, which were merged and resulted in a jail term of 4 years and 5 month (the longer of the two convictions). The time spent in police custody and preventive arrest and the time already spent in prison were to be deduced from the total time. Onţică was imprisoned at Giurgiu Penitentiary, whence he was released on January 22, 2013, after 4 years and 3 months. (It must be said that during the whole time spent at Giurgiu Penitentiary, Onţică regularly received his daily methadone dose). In total, adding the time spent in Giurgiu , in preventive arrest, and the last days, when Onţică showed up at CPAD no. 1, it turns out that he served about 4 years and 5 months in prison.
For unclear reasons, Onţică himself decided he had some more time left to serve and phoned the police on April 4, 203, then gave himself up. Although it is a simple matter of calculus (the days when he was taken into custody, to person and released are exactly known) the matter can only be solved by the court . More exactly, no one knows at present, officially, what is the time the detainee still has to serve ( days or weeks ) or whether the sentence was completed or not. Of course, his methadone treatment was interrupted as soon as he was taken into custody. Onţică’s contestation to the court regarding the remaining jail time will be heard on April 24 2013. Because of his uncertain legal status, the Rahova Penitentiary Hospital , where his methadone treatment could have continued, refused on three occasions to accept his transfer.
The physical and mental state of detainee on the day of the visit was very poor after having his methadone cut on April 5. When the door opened in Room no. 4, Onţică was lying on the floor, his legs and head in spasms. He was holding a bottle of liquid detergent and claimed he had drunk from it. It was hard to check whether he had actually ingested the substance and how much of it. But the shaking and difficulty in walking (he was actually carried by two people) indicated a precarious state of health, to say the least. During the discussion at the medical ward and later, in a room inside the police station, Onţică had moments of lucidity alternating with moments of confusion and utter nervous breakdowns. Moreover, he sweated abundantly, vomited twice and repeatedly complained of massive pains in his body, that he “could no longer stand”. In the opinion of the representatives of the Association, all his symptoms were typical for withdrawal . Onţică suggested at some point that he had hidden a few more pills of methadone, so the actual withdrawal might have started a few days after being taken into custody. But the detainee was too incoherent to take the suggestion literally. On the other hand, the only medical notification is made by the Obregia Hospital doctor on 17 April, saying that the detainee suffered from post-withdrawal, because his methadone treatment had officially ceased on April 5, and the medical examination had taken place 12 days later, therefore after withdrawal had passed.
The same doctor recommended that he should be immediately admitted into hospital, but Onţică refused because he wanted to continue his methadone treatment, not to undergo detoxification. He also refused the medication prescribed by the Obegia Hospital , knowing that neither Tramadol nor Novocalmin, nor Diazepam nor Tiapridal could replace methadone. It must be said that Onţică received his methadone substitution treatment from CAIA Obregia, an institution located in the courtyard of the Obregia Hospital .
It must also be said that in Room no. 4 of the facility (eight detainees in eight bed, on a floor surface of about 16 sq m), the other six room mates (a seventh was in court that day) confirmed that Onţică suffered from crises every day.
4. The discussions between the representatives of APADOR-CH and the director Valentin Dragomir (before and after seeing Ninel Viorel Onţică) showed that even police can change their mentalities, at least in admitting that it is necessary to continue a substitution treatment started before arrest. The director talked to Onţică for hours, he sent a request to Rahova Penitentiary Hospital for his transfer, he took him to Obregia and would have had him admitted if the detainee had not objected. In the opinion of the representatives of the Association, the only immediate solution in this case would be to take Onţică to CAIA, to get the necessary amount of methadone , or to have CAIA staff come to the facility to continue his treatment. Given the time pressure (our visit took place on a Friday and CAIA does not distribute substitutes on weekends), the director gave assurances that he would press for approval from the Medical Direction of the MoI for one of these two solutions. The representatives of the Association asked to be kept informed on the results.
• The court will decide on April 24 whether Onţică has to serve any more time in prison. If there are any days left from his term, he will be transferred to Rahova Penitentiary Hospital , where his methadone treatment will be continued. If not, he will be set free. But the 20 days of deprivation of treatment are, in the opinion of APADOR-CH, inhuman treatment, as defined by the European Court for Human Rights. The responsibility goes mainly to the Medical Direction of the MoI, where procedures for continuing substitute treatment in police custody facilities are stalled;
• The management of the Bucureşti General Police Direction had its hands tied in this case. All the efforts to transfer Onţică to the Rahova Hospital and to take him to the Obregia Hospital and the willingness to have him admitted there, the long discussions with the detainee, all remained fruitless. What the Police Direction should have done from the very start was to ask the Medical Direction to allow CAIA to step in, in the absence of procedures for continuing methadone treatment in the facility ;
• APADOR-CH asks the Medical Direction of the MoI to complete with celerity all the necessary procedures for the continuation of substitute treatment in police custody facilities. The Association reminds that substitute treatment is explicitly stipulated in normative acts which are in force: the Order of the Minister of Justice no. 1216/2006 on running integrated medical, psychological and social assistance programs for drug users deprived of freedom and Joint Order no. 282/2007 of the Ministry of Interior and Administration reform, the Ministry of Public Health and the Ministry of Labor, Family and Equality of Chances. These normative documents describe the situation of a drug addict under treatment who is deprived of freedom as a “special situation” and set clear responsibilities for the continuation of substitution treatment .
Manuela Ştefănescu Nicoleta Andreescu