Home > Changing patterns of substance misuse in adult prisons and service responses. A thematic review.

HM Inspectorate of Prisons for England and Wales. (2015) Changing patterns of substance misuse in adult prisons and service responses. A thematic review. London: Her Majesty’s Inspectorate of Prisons. 85 p.

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Drug misuse is a serious threat to the security of the prison system, the health of individual prisoners and the safety of prisoners and staff. Its effects ripple outwards to harm prisoners’ friends and families and the wider community of which they are a part. An increasing number of reports of the misuse of medication in prison and concerns that traditional supply reduction and treatment strategies were ineffective were the initial driver for this thematic inspection. However, the availability of new psychoactive substances (NPS), particularly synthetic cannabis known as ‘Spice’ or ‘Mamba’, became highly prevalent during the preparation for this report. NPS have created significant additional harm and are now the most serious threat to the safety and security of the prison system that our inspections identify. 

This thematic inspection examined the changing extent and patterns of drug misuse in adult prisons and assessed the effectiveness of the response to it. The inspection’s remit did not include tobacco and alcohol use by prisoners, which are important issues in their own right and raise significant operational and policy challenges. Of course, there are wider questions to be asked about the legal status of drugs in the community and the historical inconsistency of legal responses to various harmful substances. This report does not address those issues. There is no prospect of any relaxation of the rules governing the substances that are permitted in prisons and so there is an urgent requirement to address the harm that substance misuse causes in prisons in that realistic context. 

The report draws on the evidence of 61 adult prison inspections published between April 2014 and August 2015, the 10,702 survey responses from individual prisoners that were collected as part of those inspections, and detailed field work that was conducted in eight prisons between June and November 2014. We spoke to prisoners, prison staff and managers, drugs and health workers, and other experts. We reviewed a wide range of research undertaken by other bodies. We also considered some earlier inspection findings, where relevant. The inspection was carried out by the inspectorate’s research team and specialist health and drugs inspectors. 

Changing patterns of drug use in the community provide a useful context for understanding drug misuse in prisons. It is impossible to know for certain the extent and type of drug misuse in the community or in prisons. Nevertheless, there is a wealth of evidence to suggest that patterns of drug use are changing in the community, with drug use appearing to be reducing. The 2014–15 Crime Survey for England and Wales found that 8–9% of adults reported illicit drug use over the previous year, down from 12% in 2003–04. Cannabis remains the most widely used drug and there has been a well-evidenced decline in illicit opiate use. The reported use of prescribed medication and NPS in the community is at a relatively low level. Patterns of dug misuse vary with age, gender, geography and lifestyle. 

There are important differences between drug misuse in prisons and the community. A declining number of prisoners needing treatment for opiate misuse reflects trends in the community, although many of those requiring opiate treatment in prison have complex dependence, social, physical and mental health issues. Prisoners are more likely to use depressants than stimulants to counter the boredom and stress of prison life. The use of synthetic cannabis and diverted medication reflects a response to comparative weaknesses in security measures. Often, the price of drugs is higher and the quality poorer in prison, reflecting greater difficulty of supply. The combination of community influences, prisoner demographics and individual prison contexts means that the patterns of drug use will differ from prison to prison. As this report was being prepared, there was an acceleration in the use and availability of NPS. It is important to understand, however, that success in combating current challenges in prisons, such as the availability of NPS or specific medications, will lead to an increased demand for other drugs, and to be prepared for this.

Item Type:Evidence resource
Publication Type:Report
Drug Type:Alcohol or other drugs in general
Intervention Type:AOD prevention, AOD disorder harm reduction
Date:December 2015
Pages:85 p.
Publisher:Her Majesty’s Inspectorate of Prisons
Corporate Creators:HM Inspectorate of Prisons for England and Wales
Place of Publication:London
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Subjects:J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service
MM-MO Crime and law > Justice system > Correctional system and facility > Prison
T Demographic characteristics > Prison Inmate (prisoner)
VA Geographic area > Europe > United Kingdom

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