Drug test strips.

Synthetic Cannabinoids and the Lack of Substance Use Disorder Treatment in Carceral Settings

By Aaron Steinberg, Ada Lin, Alice Bukhman, LaToya Whiteside, and Elizabeth Matos

The inability of prisons and jails to address the drivers of and treat substance use disorders, especially during the pandemic, is leading to underexplored health ramifications for prisoners, and particularly for prisoners who identify as Black, Indigenous, or other people of color (BIPOC), who already had comparatively poorer health outcomes.

This article focuses on one substance of growing popularity in carceral settings: synthetic cannabinoids (SC), which are frequently referred to as K2 or spice.

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scoreboard with home and guests written on it at sunset time.

A Mind Is A Terrible _____ To Waste

By Vincent “Tank” Sherrill

You fill in the blank! I’ve often referred to the mind as a womb, or a laboratory of life, not a “thing,” but rather a place where thoughts and ideas are conceived. However, since COVID-19 has been introduced on the scene, I’ve watched a cold game being played inside two Washington State prisons: the game between “The Progression of the Mind versus The Regression of the Mind.”

I didn’t have a front row seat in the Colosseum to this American tragedy; I was one of the 2.3 million sacrificial bodies. (Some of these bodies were released, back into a society not prepared to receive, due to their own post-COVID health needs.)

Supposedly, under the watchful eye of Lady Justice, prisoners are afforded certain inalienable rights and privileges, like religious and education services, for the redemptive qualities they both provide. However, due to this plague of epic proportion within these walls (some ancient, and some modern), which have made my domicile for 28 years, these basic services that provide the space for the Mind to grow, develop, and reconcile ceased.

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cells with the doors closed at a historic Idaho prison.

The Pandemic Prison

By Dan Berger

The pandemic prison has utilized several of the worst features of incarceration as a foundational part of how the institution governs “public health” for its captives. And because prisons are never as removed from society as proponents like to think, these protocols redound far beyond the prison system itself.

The scale of COVID-19 in jails, prisons, and detention centers was expected. These institutions are defined by close quarters, poor health care, and, at least initially, little or no personal protective equipment. From the earliest days of the pandemic, anyone paying attention to jails, prisons, and detention centers knew that they would be vectors of community spread.

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Reflecting on Behind Bars: Ethics and Human Rights in U.S. Prisons

By Gali Katznelson

Is it justifiable to chain women as they give birth? How about confining people in a way that is proven to be psychologically devastating and torturous? These are just two of the questions raised last week during the conference, Behind Bars: Ethics and Human Rights in U.S. Prisons, a conference sponsored by the Center for Bioethics at Harvard Medical School.

To kick off the two day event, Dr. Danielle Allen delivered a moving keynote in which she urged us to question two key issues: the ethics of the treatment of those behind bars, as well as the ethics of using bars. In addressing this second point, Dr. Allen tasked everyone attending the conference with a ‘homework assignment’: to read Sentencing and Prison Practice in Germany and the Netherlands: Implications for the United States, in order to encourage us to “think the unthinkable,” namely a more humane way to treat people who have committed crimes.

From this report, I learned that in Germany and the Netherlands, incarceration is seen as a last resort for individuals convicted of crimes. Alternative non-custodial sanctioning and diversion systems such as fines and task-penalties exist – and are effective. In 2010, 6% of sanctioning resulted in incarceration in Germany and in 2004, 92% of sentences were for two years or less. These incarceration systems are organized around the principles of resocialization and rehabilitation. Time spent in prison is meant to be as similar as possible to community life, and incarcerated people are encouraged to cultivate relationships within and outside of prison. In prison, individuals can wear their own clothes, structure their own days, work for pay, study, parent their children in mother-child units, vote, and return home occasionally. In these systems, respect for persons, privacy, and autonomy are strongly held values. Solitary confinement is rarely used, and cannot exceed four weeks a year in Germany, and two weeks a year in the Netherlands.

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Mental Health First Aid Training in Prisons, Police Departments, and the Presidential Election

By Wendy S. Salkin

It has been widely reported and acknowledged that many incarcerated Americans live with mental illness. In 2014, the Treatment Advocacy Center and the National Sheriffs’ Association published The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey, a joint report that included the following findings:

  • In 2012, there were estimated to be 356,268 inmates with severe mental illness in prisons and jails. There were also approximately 35,000 patients with severe mental illness in state psychiatric hospitals. Thus, the number of mentally ill persons in prisons and jails was 10 times the number remaining in state hospitals.
  • In 44 of the 50 states and the District of Columbia, a prison or jail in that state holds more individuals with serious mental illness than the largest remaining state psychiatric hospital. For example, in Ohio, 10 state prisons and two county jails each hold more mentally ill inmates than does the largest remaining state hospital.

Similarly widely reported and acknowledged is that prisons often either cannot or simply do not serve the mental health treatment needs of those housed within their walls. As Ana Swanson of The Washington Post observed:

Unsurprisingly, many prisons are poorly equipped to properly deal with mental illness. Inmates with mental illnesses are more likely than other to be held in solitary confinement, and many are raped, commit suicide, or hurt themselves.

Solitary confinement is often used as a means of separating inmates living with mental illness from the rest of a prison population. As Jeffrey L. Metzner and Jamie Fellner reported in their March 2010 article, “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics”: Read More