Inmates are rolling up contraband nicotine patches and smoking them
Nicotine poisoning, sometimes called nic-sickness, is a real danger, says lung association
Prisoners are smoking contraband nicotine patches like cigarettes.
About $72,000 worth of nicotine patches have been seized so far this year from New Brunswick's Dorchester Penitentiary alone, news releases from Correctional Service Canada (CSC) show.
"Nicotine patches are not allowed in [federal] institutions, as they are high trading commodities," said CSC spokesperson Shelley Lawrence.
"Inmates will roll them in paper and smoke them like cigarettes," she confirmed in an emailed statement.
Nicotine patches are designed to slowly deliver nicotine into the body through a small sticker on the skin to assist with smoking cessation. They're available in different strengths, so people can gradually reduce their cravings and their body's dependence on nicotine, according to Health Canada.
Lawrence said inmates cut the contraband nicotine patches into strips, which are then rolled in paper, "usually accompanied by tea leaves," in place of tobacco.
Some other jurisdictions have reported inmates steaming or microwaving the smuggled-in patches first to remove the nicotine, then mixing it with tea leaves or orange peels. Sometimes the patches are boiled with tea leaves, which are then dried before being rolled, officials have said.
Not meant to be ingested
This type of misuse comes with "a number of dangers," according to Barbara Walls, a retired nurse and director of health programs for the New Brunswick Lung Association.
She notes the nicotine patches are designed to be slow-release and come in different strengths.
"They are not meant to be ingested in any manner and the rapid inhalation of high doses of nicotine can cause serious to fatal consequences."
These could include nicotine poisoning, sometimes called nic-sickness, or overdose, said Walls.
Some of the early symptoms could include nausea or vomiting; increased heart rate and blood pressure; quick, heavy breathing; dizziness or tremors; confusion and anxiety, according to Walls. Later symptoms can include diarrhea, extreme fatigue and weakness.
A patch designed for the first phase of withdrawal typically contains 21 milligrams of nicotine, which is supposed to slowly release over 24 hours.
According to the Atlantic Canada Poison Centre, the estimated minimum lethal adult oral dose of nicotine is 40 to 60 milligrams, although "most reported fatalities involve ingestion of much larger quantities," said spokesperson Ben Maycock.
Smoking a cigarette, which contains between 13 and 30 milligrams of nicotine, typically results in the absorption of roughly one to two milligrams, he said.
"We do not have information about abusing/misusing nicotine patches this way. And we have no cases to draw on," Maycock said in an emailed statement.
"If a patch contains 21 mg of nicotine, that's not much different than a cigarette. It is meant to be delivered over 24 hours dermally. But if you smoke it, and if it behaves the same way as a cigarette, you would absorb about 1-2 mg [of] nicotine," he said.
"I do not know if there are additional dangers of smoking nicotine patches," he added.
Walls noted "inhaling is the fastest delivery route of any drug" because it goes directly into the bloodstream.
The other concern, she said, is that "the burning of the patch material and it being inhaled is, in itself, potentially lung harmful."
Not 'an issue' in provincial jails, says province
When asked whether nicotine patches are also being smoked in provincial jails, a New Brunswick Department of Justice and Public Safety spokesperson did not initially directly answer the question.
Judy Désalliers said provincial jails have been smoke-free since 2004 and nicotine patches are not offered as an alternative.
Provincial inmates used to be able to purchase the smoking cessation patches through the offender canteen. "However, this option was discontinued due to isolated incidents of misuse," Désalliers said, without elaborating, in an emailed statement.
When pressed on whether smoking was how the patches were being misused and whether it continues to be a problem, she replied, "Nicotine patches have not been an issue within New Brunswick correctional facilities since moving to a smoke-free policy."
"Offenders requesting cessation alternatives are assessed through our medical teams and may be offered alternatives to nicotine patches," she added.
Smugglers could face criminal charges
Smoking has been banned in all federal prisons since 2008. Inmates were provided with nicotine patches for the first six months to ease their physical withdrawal symptoms. After that, they could get nicotine gum through the offender canteen.
Since nicotine patches are legal in the community, they are classified as "an unauthorized item" in prisons, said Lawrence.
Earlier this month, a package containing 70 nicotine patches was seized in Dorchester Penitentiary's medium security unit "as a result of the vigilance of staff members," according to a news release.
Lawrence did not respond to a request for more information about the incident.
If a visitor is caught trying to bring in nicotine patches, their visits would be suspended, pending a review, she said.
"There could be legal charges, if the patches are contaminated with another substance."
Offenders caught with nicotine patches "may be subject to institutional charges for possession of unauthorized items, and it is reflected within an incident report," Lawrence said.
Incident reports may impact an offender's security requirements, she added.
Nearly 30 times retail value
The total estimated institutional value of the June 6 seizure was $12,000, the release said. That works out to $171.43 per patch.
By comparison, a package of seven patches retails for about $41, or $5.86 each.
Correctional Service Canada does not have a standard list of institutional values for contraband and/or unauthorized items, "as values change according to a variety of factors," said Lawrence. In general, contraband and/or unauthorized items have a greater monetary value inside an institution than in the community, Lawrence said.
The institutional value is based on "multiple factors, but is primarily determined through intelligence information collected at the site," she said.
"Each institution's values will vary, as they depend on the regional or local jurisdiction's trends, including drug prices (if drugs were seized), as well as an institution's security level. This means that values can change on a regular basis."
On May 27, Dorchester staff seized 110 nicotine patches with an estimated institutional value of $19,000 from the medium security unit, which is rated to house up to 397 offenders.
Between April 26 and 28, 176 nicotine patches worth an estimated $31,000 were seized from the same unit.
And on Jan. 13, 50 nicotine patches worth an estimated $10,000 were seized.
All instances were being investigated by the prison, according to the news releases.
'Heightening measures to prevent contraband'
"CSC is heightening measures to prevent contraband and unauthorized items from entering its institutions, in order to help ensure a safe and secure environment for everyone," Lawrence said in her emailed statement.
"CSC continues to research and introduce new technology as it becomes available to better facilitate the detection of contraband and unauthorized items," she said.
"CSC also works in partnership with the police to take action against those who attempt to introduce these items into correctional institutions," she added.
In addition, CSC has a telephone tip line about "activities" at its prisons, such as drug use or trafficking, which "may threaten the safety and security of visitors, inmates and staff members," according to a news release.
"The toll-free number, 1-866-780-3784, helps ensure that the information shared is protected and that callers remain anonymous," the release states.
Few nicotine patch poison centre calls
The Atlantic Canada Poison Centre has handled 28 cases related to nicotine patches over the past 10 years, including fewer than five in 2021-22.
Twenty-seven of the cases dealt with exposures and the other was an "information case."
The majority of the cases involved adults, with fewer than five exposure cases among children under five years of age.
When the number is under five, exact numbers can't be provided for privacy reasons, said spokesperson Terri Fraser.
Thirteen cases were unintentional exposures (including fewer than five misuse) and six cases were intentional exposures (including fewer than five misuse).
"Of the misuse cases, they were adult, and were transferred to the [Poison Control] line from 811. They were referred to a health care facility with no cases admitted to the hospital," Fraser said in an emailed statement.
"There was a moderate outcome, one was unable to be followed, but judged as having a potentially toxic exposure."
"Of the 22 single substance exposures cases, where the outcome is related to nicotine patch exposure, nine were minimal or no effect, six experienced minor effects, [fewer] than five experienced moderate effects, and [fewer] than five were potentially toxic exposures but were unable to be followed."