Urgent action needed to curb rise in prison deaths linked to spice, say UK researchers

Researchers have called for urgent action to tackle the crisis in the Prison Service after data showed a rise in deaths among male prisoners linked to synthetic cannabinoids.

The team at Middlesex University’s Drug and Alcohol Research Centre analysed official investigation reports on the “non-natural” deaths of 129 prisoners in England and Wales between 2015 and 2020. Synthetic cannabinoids, known as “spice” and “black mamba”, were implicated in 48% – or nearly half – of the deaths, all but eight of which were in men.

Karen Duke, a professor of criminology who led the study, said the reports by the prison and probation ombudsman highlight a series of failures and shortcomings that raise the risk of drug deaths in prison. Understaffing, cuts to services, and inadequate support for the most vulnerable all contributed to fatalities, the study found.

“We were shocked at how many deaths were associated with synthetic cannabinoids. For nearly half of the deaths we analysed, spice was involved,” Duke said. “The system is in complete crisis. That’s the sense you get from these reports.”

Synthetic cannabinoids are chemical compounds that mimic the effects of THC, the active ingredient in cannabis. Spice and black mamba are often extremely potent, making them a serious threat to users. Though banned by the Psychoactive Substances Act 2016, misuse has taken off in prisons. The chemicals are often sprayed on to paper which is smuggled in, rolled up and smoked.

Writing in the Journal of Community Psychology, Duke and her colleagues describe how various factors played into the drug deaths. Those who died often had a history of mental health issues and addiction, and sometimes stockpiled drugs in order to take higher doses, or took many different drugs at once. The reports show that a failure to spot warning signs, slow emergency responses, high levels of violence and bullying, and a lack of purposeful activities for people who could be locked up for 23 hours a day, all played a role.

One man who died of synthetic cannabinoid toxicity in 2015 had collapsed three times previously and had been admitted to hospital. Even though he was suspected of taking synthetic cannabinoids shortly before his death, no action was taken. According to Duke, 35% of those who died were jailed for property crime and other non-violent offences, and might have fared better if they had been given community sentences.

“There is an urgent need for interventions and resources to address the risks, including expanded substance use and mental health treatment, harm reduction initiatives, wider sentencing reform, and improvements in the prison regime,” she said.

The findings build on recent data from the Office for National Statistics, which suggest that drug deaths in English and Welsh prisons more than quadrupled in the decade to 2019. Between 2017 and 2019, death certificates of 37 prisoners mentioned synthetic cannabinoids, making spice and black mamba the most commonly implicated drugs. The next most cited drugs were opiates, such as heroin, methadone and fentanyl, which appeared on 14 death certificates. Between 2017 and 2019, men were nearly twice as likely to die from drugs in prison than in the wider community, the data suggest.

One significant driver of drug use in prisons is the lack of purposeful activity for people who may only be let out of their cell for an hour a day. “It’s the wider context that needs tackling,” said Duke. “The response to this, every time, is to clamp down, to reduce supply. Never do you get a recommendation to look at more employment, education, training and other purposeful activities.”

Charlie Taylor, the chief inspector of prisons, said despite new technology and better security, drugs continued to be “a major problem” in many prisons. “Not only do drugs pose serious health risks to prisoners, they are also often the cause of much of the violence in prisons,” he said.

“We are finding that purposeful activity in prisons – that is education, training, employment, access to the prison library or other activities that get prisoners out of their cells and doing something useful or rehabilitative – has never been worse, and self-harm is rising.

“If prisoners are sitting in their cells for 23 hours a day with nothing to do, it can be no surprise that they turn to drugs to pass the time and deal with their frustration.”