Brewing up trouble with prison hooch
Illegal drugs may never be welcomed in the American prison system, but how about alcohol or prescription drugs?
By Lorry Schoenly, PhD, RN, CCHP
Recently published research from the Swiss and Danish prisons systems is kicking up a dust storm regarding allowing prisoners to smoke pot behind bars. Granted, the likelihood of this practice gaining steam in the U.S. system is minimal, but do we turn a blind eye to other substance use practices in our system? Illegal drug use may be frowned on in the American prison system, but how about alcohol or prescription drug use?
I have been involved with at least one prison system where officers expressed distress that the health service was tightening up on the use of prescription painkillers such as Ultram (Tramadol), an expensive and overused narcotic-like drug. The officers felt that the inmate population would be more difficult to control if the drug was withdrawn from use.
This is a valid concern. The majority of the inmate population enters the system with a substance abuse background. The substances frequently used to self-medicate physical, psychological, and emotional pain are discontinued during incarceration. Then an abrupt return of pain can lead to depression, anger, and violence. Allowing some substance use to blunt these outcomes may seem practical, but can also be dangerous for the prisoner and the officer.
Homemade alcohol is even more common than prescription painkiller overuse in the U.S. prison system. Local names for prison alcohol products include hooch, pruno, juice, buck, chalk, brew and jump. The brew is most often made from fermented fruit, but any food source will work.
The Centers for Disease Control (CDC) reported on five outbreaks of potentially deadly botulism from prison hooch in the Arizona, California and Utah prison systems. Botulism is caused by a toxin produced when a bacteria commonly found in soil is placed in an oxygen-deprived environment — like the closed containers used for DIY alcohol production. The toxin is produced during the fermentation process if no heat is applied to kill the bacteria.
Although the botulism bacteria can be introduced through any fresh food item, potato peels were identified as the source in several of the CDC-investigated outbreaks.
Signs of trouble
It’s important to act on early signs of botulism, as the nerve paralysis caused by the bacterial toxin can quickly move to the respiratory muscles and lead to death.
Often the first signs involve the eyes with double vision, blurred vision, or drooping eyelids. Slurred speech and dry mouth can follow, along with general muscle weakness and difficulty swallowing. Botulism can quickly progress to respiratory failure.
In the most recent case investigated by the CDC, seven inmates were intubated and required feeding tubes and later tracheostomies due to the extensive muscle paralysis. Fortunately, early intervention resulted in no deaths. Poisoning from botulism toxins through prison hooch can happen in a few hours or take up to 10 days to appear. A medical evaluation of symptoms is necessary to rule out other possible causes of progressing paralysis. Information about the potential of pruno-partaking is important for a quick diagnosis and response.
So, if home-brewing is a popular hobby at your facility, be particularly alert for signs of botulism poisoning among those who make and partake of this beverage. It may seem like a harmless way to keep the prisoners peaceful and preoccupied — but it also has potential to brew up some trouble.
What about your facility’s culture on inmate substance use? Share your thoughts and suggestions in the comments section of this post.