The High Court has refused an application for leave to bring a judicial review over the decision not to prescribe Pregabalin to a prisoner detained at Castlerea Prison.
In a ruling delivered on 30 January 2024, Mr Justice Garrett Simons said the clinical decision to discontinue the medication was appropriate and proportionate. He also found that the Irish Prison Service was providing healthcare services equivalent to those available to people entitled to General Medical Services in the community, and that the applicant’s right to bodily integrity was being respected.
The applicant said he had previously been prescribed Pregabalin, also known as Lyrica, by his GP for pain related to nerve damage in his wrist. He said he was experiencing significant pain and stress after being denied the medication.
An affidavit from the Irish Prison Service’s National Operational Nurse Manager said the decision followed a clinical assessment. The court was told that the applicant had a history of polysubstance abuse and opioid dependence, and that Pregabalin has significant potential for dependence. After his committal on 19 March 2023, he was assessed by a GP. A further assessment the following day led to a decision, made with his consent, that he should stop taking Pregabalin.
The affidavit described alternative pain medicines prescribed during his detention, including Brufen, Amitriptyline, Keral, Omeprazole and Neurontin. Prison authorities also referred him to a physiotherapist and a plastic surgeon. The ruling records that he declined an x-ray appointment in June 2023 and refused appointments for plastic surgery outpatient care and physiotherapy in September and November. After a self-inflicted injury in November, he was reviewed by a GP and referred for psychotherapy and to a pain specialist at University Hospital Galway.
Justice Simons said the prison authorities could take account of the medication’s addictive potential and the applicant’s history when deciding on his individual treatment plan. He noted that the Irish Prison Service had no blanket ban on such medicines and that the decision was supported by IPS and Health Products Regulatory Authority guidance.
The ruling concerned leave to apply for judicial review, which had been directed to proceed on notice to the respondents. The court refused leave; it did not determine a substantive judicial review challenge. The registrar was asked to send the ruling and order by registered post to the applicant and copies to the Chief State Solicitor for the respondents.