From the Outside-In: Drug Use in Prisons

In the midst of the opioid epidemic, over 115 peopleare dying from overdose every day in the United States. Across the country, law enforcement officials have rushed to stem drug sales and use, cracking down on those found to be in possession of drugs. Arrests relating to drug possession have skyrocketed, and the accused are filling up the nation’s already-overcrowded prison system. But putting someone behind bars does not treat physical dependency, and many prisoners are suffering from addiction. Even in some of the country’s most fortified structures, prisoners are often unable to escape the drugs that have taken control over their lives. Drugs are making their way into prisons. “A lot of the problems that exist on the outside are also on the inside,” explains Emory professor Dr. Jon Zibbell, pointing to how the opioid epidemic has filtered into the country’s jails. Between 2006 and 2008, a total of 44 California prisoners experienced fatal overdoses. One prison in Essex found 28 drug packages and 44 cell phones in a single month. “Bad batches” of contaminated drugs could cause outbreaks of disease and overdose.

The primary culprit: a synthetic cannabinoid called K2, which takes the form of a liquid or a plant sprayed with chemicals. The synthetic cannabinoid made headlines again recently when Aaron Herndandez, a former Patriots star and convicted murderer, committed suicide in his cell. A nearby inmate told prison officials that Hernandez had “spent the last two days smoking K2 in his cell and he wasn’t in the right frame of mind,” an allegation that was not included in the public report. Officials deny that Hernandez was on drugs at the time of his suicide. The inmate claimed that widespread use of K2 has infiltrated the prison, saying that “That sh** is [expletive] all these young kids up” and that users and deliverers are so determined that “they aren’t going to stop no matter what happens in here.”

But how do drugs make it past the guards, bars, and their army of detection equipment in the first place? Drugs have been smuggled into prisons using a variety of creative ways, such as mailing books soaked with the liquid or hiding it in the mouths of visiting girlfriends who kiss their partners. Technology has also upped the game: in Britain, a gang who used drones to make 55 drug deliveries in between April 2016 and June 2017 was arrested. Using contraband cell phones to communicate, the gang delivered drugs directly to the prisoners’ windows. Making the problem even more difficult is the fact that K2 only remains in the blood for a short amount of time, making it hard to detect in standard tests.

Prisons are now scrambling to fight the influx of drugs. In Pennsylvania, which is known for its no-tolerance drug policy in prisons, uses an intricate network of canines, mailroom X-rays, and steep punishments. But after 29 workers were sickened from exposure to K2, the state has announced new policies to more vigorously monitor donated books and implement drone detection equipment. So far with the new policy, drug finds and positive testings have been halved, and assaults and misconduct have decreased.

But some think that prison policies should go in a different direction. Many experts, including Dr. Zibbell, believe that prison systems should use a harm-reduction approach. Harm-reduction is founded in the principle that it would be impossible to fully eradicate drug use from society. Rather than attempt to completely stop the problem, proponents of this approach believe that it would be more helpful to instead focus on how to minimize the negative effects of drug use. Wardens and officials are often hesitant to apply such principles, fearful to admit that prisoners are using drugs, but Zibbell asks,“Why not start with reality rather than a moral supposition of what should be?” Accordingly, guards should carry naloxone and receive training on how to react to an overdose. Meanwhile, prisoners should be educated on how to react when someone experiences an overdose. 

Perhaps most importantly, Zibbell proposes that anyone entering prison should be offered the option of a methadone program. This is because many people enter prison already addicted to drugs. This measure could help curb addiction and prevent smuggling, both in jail, and later out of it. This is because while in jail, many prisoners lose their tolerance to opioids, and are thus more vulnerable to overdose when they leave. An approach similar to the one described by Zibbell was launched in Rhode Island prisons in 2016. By screening inmates for dependence disorders and offering treatment, the state managed to cut 12% of all overdose deaths and 61% of post-incarceration overdose deaths.[1] Shifting this strategy to a larger audience could potentially save thousands of lives. Ultimately, treatment may be more effective than punitive measures. Zibbell says that people deserve to receive care for their addictions, explaining that “if you were a nonviolent drug offender and your charges are drug possession, you should absolutely be given treatment and not jail. Because basically you’re not doing anything wrong, other than being addicted to something.” 

Reference:

[1] Clarke, J. G., Martin, R. A., Gresko, S. A., & Rich, J. D. (2018). The First Comprehensive Program for Opioid Use Disorder in a US Statewide Correctional System. American Journal of Public Health, 108(10), 1323-1325. doi:10.2105/ajph.2018.304666