The Advisory Council on the Misuse of Drugs (ACMD) has taken notice of emerging evidence on the increasing drug-related harms in prisons and related to transitions through the criminal justice system. In particular, the increased risk of death, including by overdose, in the weeks immediately following release to the community. 

Previous reports by other experts in this field, including the group led by Lord Patel in 2010, had made recommendations to improve continuity of care. However, the extent to which these have been implemented across government is unclear. The ACMD sought to determine the most important existing recommendations and to what extent these had been implemented, and whether there was a need for new or adapted recommendations. 

The ACMD invited stakeholders from government departments, service providers, and charities, amongst others, to submit evidence to the inquiry. The ACMD examined the evidence and identified substantial harms associated with transitions by people who have drug-related problems, including:

• High incidence of homelessness. Many prisoners under supervision from the National Probation Service or Community Rehabilitation Companies are discharged to unsettled or unknown accommodation on their first night of release. This increases the risk of relapse and reoffending.
• Adults serving sentences of less than 12 months in England and Wales had a reoffending rate of 64.4% between April and June 2017, with rates likely to be even higher among those with a drug problem.
• Increased risk of death. Death rates among those on post-release supervision, are many times higher than in the general population. The first few weeks immediately following release to the community is the highest risk period.
• Custody as an opportunity to reduce drug problems and offending was often squandered by failure to provide support on release. 

There has also been a lack of systematic follow-up on and the fragmentation of responsibility for implementing previous recommendations. Previous reports had highlighted continuity of care as being critical. However, the latest data from PHE suggest that only 32.1% of people assessed as needing treatment when they leave prison enter treatment in the community within 21 days of release.