The prevalence of deadly opioids in western Canadian prisons has inmates and the officers who guard them increasingly fearful the drugs could be weaponized, a new University of Alberta study suggests.
"It is this prospect that fentanyl is being (or could be) weaponized that represents the most dramatic change fentanyl is producing in prison," according to the study, recently published in the International Journal of Drug Policy.
"Prisoners involved in upper level gang activities, or who occupied the higher ranks of organized crime groups, told us 'not every overdose you see is actually an overdose. It's called Mr. Murder for a reason.' "
The study was the first in Canada to investigate how opioids have shaped the prison experience for inmates and altered the work of correctional officers.
Sociologists Kevin Haggerty and Sandra Bucerius interviewed 587 inmates and 131 correctional officers in four prisons, including two remand centres.
Despite efforts to keep them out of correctional institutions, drugs like fentanyl and carfentanil are readily available and pervade almost every aspect of prison life.
"This came about inadvertently," Haggerty said in an interview Tuesday with CBC Radio's Edmonton AM. "When we started out, we were interested in whether there was radicalization in prisons.
"What we heard is radicalization is not a problem. This is a problem."
Prisoners told researchers they were increasingly concerned about the prospect of overdosing, the study said. The extreme potency of fentanyl and carfentanil means users can overdose on small amounts and the opioids are often mixed into other street drugs.
Most survey participants told researchers the opioids they purchase are often mixed with baby powder, powdered sugar or other street drugs.
You smoke a joint or something, and now you're all fentied out. - Inmate
"For the inmates, the real concern is overdoses and poor mixing practices, so they don't know what they're taking. You're seeing a lot more overdoses," Haggerty said.
"And then that spills over into the world of correctional officers, who are concerned about inadvertent exposure and concerned about what this is doing to the job."
'Anything can be laced'
One inmate told the researchers, "it's everywhere. It's in your cocaine. It's everywhere. They're sprinkling it on pot ... . It's because it's addictive. You smoke a joint or something, and now you're all fentied out."
Some inmates were concerned that even their food could be laced. About 10 per cent of those interviewed refused to consume anything but pre-packaged food.
"You don't know what's in that bag of chips, you know?" one inmate said. "You can't trust no one anymore. Anything can be laced."
Adding to the overdose risk was the perception that prison is a relatively safe place to consume drugs, since officers are equipped with naloxone and monitor prisoners for overdose symptoms.
"You take turns," said one inmate. "Your buddy uses and you watch, and then you use and your buddy watches. Kind of like spotting at the gym."
Prisons do not release statistics on overdoses, but the study suggests that in a given month on a particular prison unit — typically housing between 50 and 80 inmates — overdoses ranged from zero to nine, depending on the facility.
The prevalence of opioids is also taking a toll on correctional officers, the study said.
Fear of personal exposure to the drug and the trauma of repeatedly resuscitating inmates has made the work more daunting.
About one-third of the officers interviewed said they are considering leaving their jobs because of the perceived risks.
"It's like in two weeks, I've probably seen three or four blue bodies come back to life, because of Narcan," one guard recounted. "They were shot three or four times. I've done chest compressions on a guy who was vomiting all over himself."
The study raises questions about how well Canadian prisons are equipped to deal with the ongoing epidemic. The research suggests programs that focus on harm reduction may be the answer, Haggerty said.
"There are going to be people who are going to continue to use, so we need to think about ways we can manage that addiction," Haggerty said.
"Crisis presents opportunities, because clearly there are concerns about people's health and people are dying."