Columns share an author’s personal perspective.
States and large municipalities have been releasing prisoners to slow - not stop - the spread of the novel coronavirus within correctional facilities.
While these mitigation efforts deserve praise for valuing life and health over punitivity, we don’t need a recidivism crisis on top of a pandemic; we need to do something to ensure that returning citizens don’t reoffend.
There is a way to do it. It’s just never been tried before - at least not with this population, one that may need it the most.
It’s hardly a secret that prison populations are trauma history-heavy. People who commit crimes are driven not by their spirits but by their wounds.
Women associated with the justice system have experienced higher rates of trauma, as well as higher rates of substance use, compared with the general population. Eighty-six percent have experienced sexual violence, according to the Vera Institute of Justice in 2016, 77% have experienced partner violence and 60% have experienced caregiver violence. Washington University researchers in 2018 deduced that male prisoners have a point prevalence rate of PTSD that’s five times higher than that of the general population.
Even if people don’t enter prison with a backstory loaded with neglect and abuse, they often leave with one. Researchers have discovered Post Incarceration Syndrome, a psychic injury related to the harsh conditions and institutional living in carceral settings. And as many as half of the people who need mental health treatment don’t get it when they’re in custody, NPR reported last year, which likely contributes to the reason why inmates released from state prisons have a 5-year recidivism rate of 76.6%, according to Bureau of Justice Statistics.
The stellate ganglion block - an anesthetic injection into a specific set of nerves - was designed to relieve chronic pain and was successfully used off-label for depression as early as 1945 at The Cleveland Clinic.
Unfortunately, its potential for psychiatric impact was forgotten for 53 years, until 1998, when a Finnish physician treated a patient who was suffering from both severe hand sweating and PTSD. Unexpectedly, the patient reported relief both on his palms and in his mind.
About 10 years later, because of its lack of side effects and enduring benefits (some shots last eight years), physicians began to accept SGB as a potential way of managing PTSD in veterans. In one study, published in 2014 in Military Medicine, 80% of patients administered an SGB injection reported alleviation of their PTSD symptoms after only one shot.
The status of SGB as a treatment isn’t clear. It’s yet to be formally approved by the FDA, yet some military doctors administer the shot to patients.
Prisoners suffer from PTSD at even higher rates than veterans - 11% to 20% of former service members are reported to have PTSD - and their illness comes with even higher social costs.
It’s time to approve SGB for voluntary use for people leaving carceral settings. A total of 56 SGB studies have been either completed or remain underway, according to the U.S. National Library of Medicine, but we’ve known about the SGB block for almost a century. It’s not a new psychotropic drug; it’s a widely used anesthetic that simply shorts out certain nerves so that the seductively self-defeating trauma response stops. The SGB doesn’t flood people’s brains with chemicals and numb them, freezing them into emotional stillness. It blocks interference of past events by blocking nerve growth factor, which increases during times of stress and fear - two guaranteed conditions for someone who leaves prison during a deadly pandemic.
Researchers sought and received approval to try SGB for other medical conditions - relief of hot flashes, vertigo - that are hardly more pressing than people suffering PTSD so severely that the social contract becomes negotiable.
Right now medical regulatory agencies are thinking differently - not just because they have to, but because they can. The Food and Drug Administration is able to fast-track coronavirus testing kits and other treatments because President Donald Trump declared a national state of emergency for COVID-19 almost two months ago. The agency is now empowered to grant emergency use approvals that would have been impossible before. Approving SGB shots for released inmates should be on the FDA’s list.
Some may doubt that using SGB in prisons can be a panacea for abnormal behavior, and they may be right. But we won’t know until we try, and now - when people are prioritizing health over other considerations - is the perfect, if not the only, time to do it.
Chandra Bozelko writes the award-winning blog Prison Diaries. You can follow her on Twitter at @ChandraBozelko and email her at firstname.lastname@example.org.
Bozelko column: Try stellate ganglion block on released prisoners
Columns share an author’s personal perspective.