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You can find the current article at its original source at https://www.theguardian.com/commentisfree/2018/may/16/spice-epidemic-uk-prisons-nurses-psychoactive-drugs-jails
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| The spice epidemic in UK prisons is putting nurses at risk | The spice epidemic in UK prisons is putting nurses at risk |
| (25 days later) | |
| Let’s get this out of the way first – nursing staff want to deliver the best care they can, whether their patient is a prisoner, a pensioner or both. | Let’s get this out of the way first – nursing staff want to deliver the best care they can, whether their patient is a prisoner, a pensioner or both. |
| But the explosion of psychoactive drugs in UK prisons poses challenges that didn’t exist even five years ago. The risks inherent in this new breed of powerful synthetic drugs – sold under a variety of brand names – are poorly understood both by users and the clinicians who treat them. | But the explosion of psychoactive drugs in UK prisons poses challenges that didn’t exist even five years ago. The risks inherent in this new breed of powerful synthetic drugs – sold under a variety of brand names – are poorly understood both by users and the clinicians who treat them. |
| Any drug bought on the street should always be treated with suspicion, as canny users know. But spice, and other drugs like it, are a different thing altogether. These are new compounds, untried and untested. The chemical makeup can change batch by batch, with correspondingly varied effects. | Any drug bought on the street should always be treated with suspicion, as canny users know. But spice, and other drugs like it, are a different thing altogether. These are new compounds, untried and untested. The chemical makeup can change batch by batch, with correspondingly varied effects. |
| A rapid heartbeat, disorientation, aggression or unconsciousness are just a few of the most common symptoms, but situations can change rapidly. A violent, screaming prisoner can collapse suddenly into unconsciousness. At worst, these drugs kill. | A rapid heartbeat, disorientation, aggression or unconsciousness are just a few of the most common symptoms, but situations can change rapidly. A violent, screaming prisoner can collapse suddenly into unconsciousness. At worst, these drugs kill. |
| In the ruthless world of prison drug dealing, it’s often the most vulnerable detainees who suffer the most. Dealers looking to test their merchandise may offer a “free” sample to those with learning difficulties or other vulnerabilities. Or they may simply force them to take the drug to see what happens. In Birmingham in March, several people are thought to have died, one of them an inmate at Winson Green prison, after taking a particularly toxic batch of mamba, a synthetic drug similar to spice. | In the ruthless world of prison drug dealing, it’s often the most vulnerable detainees who suffer the most. Dealers looking to test their merchandise may offer a “free” sample to those with learning difficulties or other vulnerabilities. Or they may simply force them to take the drug to see what happens. In Birmingham in March, several people are thought to have died, one of them an inmate at Winson Green prison, after taking a particularly toxic batch of mamba, a synthetic drug similar to spice. |
| It is no coincidence that a homeless man in Manchester, where 90 to 95% of the homeless population are thought to smoke the drug, has said that spice is worse than heroin. | It is no coincidence that a homeless man in Manchester, where 90 to 95% of the homeless population are thought to smoke the drug, has said that spice is worse than heroin. |
| So when a prisoner with multiple serious health conditions is lying unconscious in a small, unventilated cell swirling with toxic smoke, a prison nurse or healthcare assistant faces a stark choice. | So when a prisoner with multiple serious health conditions is lying unconscious in a small, unventilated cell swirling with toxic smoke, a prison nurse or healthcare assistant faces a stark choice. |
| A basic principle of emergency response is to assess the danger posed to responders before rushing in. You are not helping anyone by becoming a casualty yourself. But under existing guidance, prison staff – including nurses and healthcare assistants – have a duty to enter that cell. They are expected to administer care, almost regardless of the risk to themselves. | A basic principle of emergency response is to assess the danger posed to responders before rushing in. You are not helping anyone by becoming a casualty yourself. But under existing guidance, prison staff – including nurses and healthcare assistants – have a duty to enter that cell. They are expected to administer care, almost regardless of the risk to themselves. |
| Of course, the existing guidance was written with the effects of secondhand cigarette smoke in mind. A risk to be sure, but hardly the same level of risk posed by spice. The results are not surprising. We have had members knocked unconscious after inhaling smoke – one person had to be defibrillated in the back of an ambulance on the way to A&E. | Of course, the existing guidance was written with the effects of secondhand cigarette smoke in mind. A risk to be sure, but hardly the same level of risk posed by spice. The results are not surprising. We have had members knocked unconscious after inhaling smoke – one person had to be defibrillated in the back of an ambulance on the way to A&E. |
| We have had members reporting nausea and hallucinations, members with debilitating headaches, members unable to drive themselves home after inadvertently inhaling smoke in the course of their duties. And these are not isolated incidents. | We have had members reporting nausea and hallucinations, members with debilitating headaches, members unable to drive themselves home after inadvertently inhaling smoke in the course of their duties. And these are not isolated incidents. |
| This week, a nurse told me he had treated more than 50 prisoners for the effects of spice in less than a week. And that’s in just one prison. An NHS trust recently withdrew its staff from a whole wing of HMP Holme House in County Durham after it became too dangerous for them to administer care. | This week, a nurse told me he had treated more than 50 prisoners for the effects of spice in less than a week. And that’s in just one prison. An NHS trust recently withdrew its staff from a whole wing of HMP Holme House in County Durham after it became too dangerous for them to administer care. |
| Spice is far from the only drug causing problems in UK prisons, but why is it so prevalent? The simple answer is that it’s both cheap and easy to smuggle in. A popular method is to impregnate the flap of an envelope with the substance. All the recipient has to do is tear off the flap and roll a cigarette with the drug-infused paper. | Spice is far from the only drug causing problems in UK prisons, but why is it so prevalent? The simple answer is that it’s both cheap and easy to smuggle in. A popular method is to impregnate the flap of an envelope with the substance. All the recipient has to do is tear off the flap and roll a cigarette with the drug-infused paper. |
| Nurses falling ill after inhaling spice fumes in prisons, says union | Nurses falling ill after inhaling spice fumes in prisons, says union |
| But hard as it may be to solve, we owe it to prison staff to bring the situation under control. Our colleagues at the Prison Officers’ Association say the spice epidemic in UK jails is now “beyond crisis point”. We agree. We want to see an immediate review of the guidance that takes into account the risks posed by synthetic psychoactive substances, both to prisoners and the staff responsible for their wellbeing. | But hard as it may be to solve, we owe it to prison staff to bring the situation under control. Our colleagues at the Prison Officers’ Association say the spice epidemic in UK jails is now “beyond crisis point”. We agree. We want to see an immediate review of the guidance that takes into account the risks posed by synthetic psychoactive substances, both to prisoners and the staff responsible for their wellbeing. |
| On Monday, Michael Spurr, chief executive of HM Prison and Probation Service, agreed to meet with the Royal College of Nursing and NHS England to discuss what needs to be done. | On Monday, Michael Spurr, chief executive of HM Prison and Probation Service, agreed to meet with the Royal College of Nursing and NHS England to discuss what needs to be done. |
| This is not before time. Getting the right people around the table is a good first step, but action has been delayed too long already, and our members on the ground describe a situation that sounds increasingly out of control. | This is not before time. Getting the right people around the table is a good first step, but action has been delayed too long already, and our members on the ground describe a situation that sounds increasingly out of control. |
| And until action is taken, both prison staff and prisoners will continue to suffer the insidious effects of this potentially deadly drug. | And until action is taken, both prison staff and prisoners will continue to suffer the insidious effects of this potentially deadly drug. |
| • Brian Morton is national officer at the Royal College of Nursing | • Brian Morton is national officer at the Royal College of Nursing |
| Prisons and probation | Prisons and probation |
| Opinion | Opinion |
| Drugs | Drugs |
| Nursing | Nursing |
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