A worrying increase in drug-related prison deaths involving ‘Spice’ is highlighting a crisis in the prison system, according to new research.
Synthetic cannabinoids, also known as ‘Spice’ and ‘Black Mamba’, were implicated in 62 (48%) of 129 non-natural deaths between 2015 and 2020 in English and Welsh prisons based on analysis of reports from the Prison and Probation Ombudsman, an independent body which investigates all fatal incidents.
New psychoactive substances (NPS), often called ‘legal highs’ and which were made illegal in prisons under the Psychoactive Substances Act in 2016, have been widely used in prisons for more than a decade because they are considered to be cheaper and less detectable.
"Some of the people who died were imprisoned for very low-level offences, 35% were jailed for property crime and other non-violent offences, and having a community sentence might have allowed better treatment for their substance dependency or mental illness. Reducing harm has to be the most important first step in trying to prevent someone from having an overdose or dying from drugs." Karen Duke, a Professor of Criminology at Middlesex University.
The study found “a clear lack of reaction and understanding” around NPS risks among prison staff and those imprisoned and in some cases “warnings signs were missed or ignored”, particularly from 2015-2016.
Co-author Karen Duke, a Professor of Criminology at Middlesex University, said: “Spice has been the most widely used new psychoactive substance in prisons and has taken over from herbal cannabis and to a certain extent heroin which used to be the drugs of choice in prison settings.
“The substance can be liquidised and sprayed onto paper which is smuggled in, rolled up and smoked.
“Just a little bit of Spice can be very potent.”
One man who died in 2015 of the toxic effects of synthetic cannabinoids causing pulmonary oedema and congestion had collapsed three times previously and been admitted to hospital. Although he was suspected of taking NPS in the lead up to his death, no action had been taken.
Another death of a man in the same year was caused by a cocktail of drugs including methadone, buprenorphine, diazepam, quetiapine, gabapentin, Buscopan and synthetic cannabinoids - highlighting dangers linked to combining substances.
In this case, the cell mate said that the prisoner used Black Mamba on the night of his death and smoked it most nights combined with Buscopan.
The research, undertaken by Middlesex University’s Drug and Alcohol Research Centre, revealed various factors related to behaviour, individuals, circumstances and environments contributed to the deaths.
Of the 129 prisoners who died, 94% were male, 88% had a history of substance misuse and in 57% of cases there was a reference to mental health issues.
Middlesex University academics say the findings show that low-level offenders, with a history of substance misuse and mental health issues, should have been given community sentences and there must be a focus on specialist therapies in prison rather than an abstinence model.
Professor Duke said: “Some of the people who died were imprisoned for very low-level offences, 35% were jailed for property crime and other non-violent offences, and having a community sentence might have allowed better treatment for their substance dependency or mental illness.
“The drug trade in prison is impossible to stop and is always going to adapt to whatever security measures are put in place.
“Reducing harm has to be the most important first step in trying to prevent someone from having an overdose or dying from drugs.
“Some people aren’t ready for complete abstinence and they might want to have a reducing or maintenance regime.
“You need a variety of treatment options, not just one or the other. If we move away from this abstinence model which is dominant in prisons, we might start to address some of the issues.
“There’s a wider connection between the crisis in the health service and the prison service and when they collide in this space which is riddled with problems it is explosive.”
Co-author Betsy Thom, a Professor of Health Policy at Middlesex University, said: “A lot of this group have unmet needs prior to prison and arrive with a whole set of problems which are not being addressed.
“They then get released from prison without adequate access and follow-up provision, especially to the mental health or drug treatment services they urgently need.
“Prison alone isn’t the solution, it needs to be linked to what’s happening in the community with people who use drugs.”
Study co-authors from Middlesex University also include Dr Helen Gleeson, a Research Fellow, and Professor Susanne MacGregor, an Emeritus Professor.
The research paper - The risk matrix: Drug‐related deaths in prisons in England and Wales, 2015–2020 – has been peer reviewed and published in the Journal of Community Psychology.
*New figures from the Office for National Statistics reveal 68 prisoners lost their lives to drugs in jail between 2017-2019. Synthetic cannabioids featured on 37 related death certificates, more than any other substance mentioned.
Find out more about Middlesex University's Drug and Alcohol Research Centre.