Pedro Sabalsa-Mendez is suggesting his marijuana use may have contributed to the psychotic delusions he experienced when he murdered Avi Feldman at an Ashland party.
Details about Sabalsa-Mendez's current mental state emerged during a hearing this week in which he appeared via video before the Oregon Psychiatric Security Review Board. The Mail Tribune obtained an audio recording of the hearing.
Sabalsa-Mendez was found guilty of murder except for insanity in August after stabbing Feldman, 20, to death on Nov. 6, 2016. Sabalsa-Mendez is being held at an Oregon State Hospital psychiatric facility in Junction City. He has been diagnosed as having schizophrenia, a chronic mental illness that causes hallucinations and delusions.
At the time of the murder, Sabalsa-Mendez, then 22, thought he was on a CIA mission to kill Feldman. He also thought Feldman was trying to crucify his soul.
Sabalsa-Mendez is starting to question the role drugs may have played in the murder, according to testimony at the hearing.
"Very recently, as in the last week and a half, Mr. Sabalsa has expressed a lot of concern that his symptoms could be substance-induced," Dr. Matie Trewe told the board.
However, Trewe said Sabalsa-Mendez has been diagnosed with schizophrenia.
"It appears to have been active at the time he committed his offense," she said.
Sabalsa-Mendez said he was using more marijuana at the time than he previously disclosed, according to a recent evaluation report.
However, prior to the murder, Trewe said Sabalsa-Mendez was seen at least twice at Asante Rogue Regional Medical Center for psychotic symptoms. Toxicology tests were performed and he tested negative for drugs.
"To me, that makes it extremely unlikely that his substance abuse alone was responsible for his psychotic symptoms," Trewe said.
Sabalsa-Mendez believes he was using drugs at the time of the hospital visits, Trewe said.
At the time of the murder, he had marijuana in his system, according to a urine test.
Trewe said it's not uncommon for people with mental illness to wonder about the impacts of drug use.
"I think this ambivalence and questioning of diagnosis is very common in young people with a new diagnosis," Trewe said.
According to police reports, Sabalsa-Mendez did not have a long history of mental illness. His mother told police he began showing symptoms of mental illness, including hallucinations, in March 2016.
Schizophrenia often emerges in the teen years or in early adulthood. Some researchers theorize it is caused by overactive pruning of the connections between neurons in the brain. Pruning occurs naturally and is at its height during adolescence as nature streamlines the brain.
Drugs like methamphetamine are also known to induce schizophrenia-like symptoms, including hallucinations and delusions. The symptoms gradually disappear if people stop using meth, unless they have permanent brain damage.
A 2017 review of studies showed marijuana is likely to increase the risk of developing schizophrenia, according to a committee appointed by the National Academies of Science, Engineering and Medicine.
Some people have been mistakenly judged guilty except for insanity when their symptoms were actually due to drug use.
Heather Marie Everman stabbed a man in Medford in 2014 and was found guilty of second-degree assault except for insanity in 2015. Although she was sentenced to spend up to 10 years under the jurisdiction of the Psychiatric Security Review Board, she was released in 2016 after her symptoms faded away and officials decided she actually had been experiencing drug-induced psychosis.
Since her release, Everman has continued to run afoul of the law for allegedly possessing methamphetamine, fighting with law enforcement personnel, trespassing and stealing, court records show.
Everman also has been found mentally unfit to aid and assist in her own defense in the new cases — raising questions about her actual mental state, her drug use and the interrelationship between the two.
Since the Everman case, the Jackson County District Attorney's Office has taken a tougher stance on potential insanity cases, pushing for prison sentences when it believes methamphetamine-fueled delusions and hallucinations — rather than an underlying mental illness — contributed to violent crimes.
Senior Deputy District Attorney Laura Cromwell, who handled the Sabalsa-Mendez case, said it's not uncommon for Oregon State Hospital patients and their defense attorneys to argue symptoms were triggered by drug use. The argument could win a patient's release.
Sabalsa-Mendez tested positive for marijuana after murdering Feldman. Other drugs and alcohol were not found in his system, Cromwell said.
"I think anytime something comes back positive, that's the only shot. They have to put that defense out there," she said. "I'm not concerned at all in this case. We've had two separate psychiatrists say he actually is suffering from schizophrenia. I think it's normal for him to put that out there. It has been a common defense — sometimes warranted and sometimes not."
In anticipation that Sabalsa-Mendez would make a drug intoxication argument before the Psychiatric Security Review Board, Cromwell had him sign a statement in August that “neither controlled substances nor alcohol played a substantial role" in his actions during the murder.
After the murder, Sabalsa-Mendez was placed on anti-psychotic medications which caused negative side effects, including sedation. Trewe testified at the hearing she switched him to Abilify and he has had better energy, motivation and affect, with no recurrence of psychotic symptoms.
About two weeks ago at his request, she began gradually tapering his medication. He is now on a lower dose of Abilify, Trewe said.
She testified she wants to hold the dose at that level and monitor for any symptoms. Trewe believes his psychotic symptoms could re-emerge on a low dose of medication or if he goes off his medication.
But she said it's better for Sabalsa-Mendez to attempt to wean off the medication in a safe environment in the hospital.
"I think he has the capacity at this time to make that decision and that we can safely manage if he does have re-occurring symptoms," Trewe said.
She said he has been very pleasant and cooperative in the hospital, and understands that delusions and hallucinations he has experienced are not real.
"He really has been a pleasure to work with," Trewe said.
Cromwell said Sabalsa-Mendez was able to behave well toward others for periods of time, including police officers.
"He really was always incredibly pleasant, but his unpredictability was what was so scary about him," she said.
One PSRB member raised concerns that Sabalsa-Mendez had a high score on a test for malingering.
Malingering is the fabricating of symptoms of a mental or physical illness. It is also defined as deliberately pretending to have an illness.
Trewe said the evaluation for malingering is an imperfect test.
A high score could indicate a person is feigning mental illness but doesn't have a good understanding of actual symptoms, she said.
Alternately, it could just be a cry for help, evidence the person wasn't paying attention during the test or was simply trying to please the examiner with the "right" answer. It could also be a sign of disordered thinking, Trewe said.
Disordered thinking, a common symptom of schizophrenia, makes it difficult for a person to think and communicate in a logical, orderly way.
Sabalsa-Mendez is not being released from the mental hospital.
Through his attorney, Sabalsa-Mendez agreed that he has a mental disease or defect that, when active, causes him to be a substantial danger to others. He did not contest the PSRB's jurisdiction over him.
His attorney said Sabalsa-Mendez is not seeking any kind of release option at this time, and understands he has work to do before he is a good candidate for release.
Defendants judged guilty except for insanity can eventually be released or moved to a lower level of care if their mental condition improves.
Patients at the Oregon State Hospital have the right to request a hearing before the board every six months. The hospital can request a hearing at any time.
If the board receives no hearing requests, it will hold a hearing every two years to review the patient's case.
— Reach staff reporter Vickie Aldous at 541-776-4486 or firstname.lastname@example.org. Follow her at www.twitter.com/VickieAldous.