In 1997, it was observed that prison suicide patterns in Ireland mirrored those in neighbouring jurisdictions and that numbers had increased markedly over the previous 10 years.1 A 1999 report noted that although most deaths were judged to be suicides, there had been an increase in deaths due to drug overdoses.2 A systematic survey of mental health in Irish prisons found that 69% of prisoners reported significant substance or alcohol misuse issues prior to committal.3 In order to plan preventive measures, an investigation was commissioned by the National Suicide and Harm Prevention Steering Group to review the deaths of prisoners in Ireland between 2009 and 2014.4 Coroners’ findings were analysed, including postmortem tests, to assess whether drugs played a role or not.

In all, there were 69 deaths in custody over this period, of which 38 were deemed to be not from natural causes. Sixteen cases involved drug overdoses. Another eight deaths, all due to hanging, were linked to drug taking. Drug tests showed that two other deaths were also associated with the use of drugs. The drugs involved in the deaths included non-prescribed benzodiazepines, opiates, cocaine, cannabis, codeine, and other psychoactive substances. Many also had alcohol and prescription drugs in their system.

The investigation noted that 14 of the 38 prisoners died while on temporary release, suggesting that imprisonment may offer partial protection and that continuity of care post-release is crucially important. The study authors suggest that friends and family members who visit prisons should be made aware that bringing in contraband is a major contributory factor to unnatural deaths in custody, including deaths by hanging.

1 Dooley E (1997) Prison suicide – politics and prevention: a view from Ireland. Crisis, 18(4): 185–90.

2 Department of Justice (1999) Report of the National Steering Group on Deaths in Prisons. Dublin: Stationery Office. https://www.drugsandalcohol.ie/5391/

3 Kennedy HG, Monks S, Curtin K, Wright B, Linehan S, Duffy D, et al. (2005) Mental illness in Irish prisoners: psychiatric morbidity in sentenced, remanded and newly committed prisoners. Dublin: National Forensic Mental Health Service. https://www.drugsandalcohol.ie/6393/

4 Iqtidar M, Sharma K, Mullaney R, Kelly E, Keevans M, Cullinane M, et al. (2018) Deaths in custody in the Irish prison service: 5-year retrospective study of drug toxicology and unnatural deaths. BJPsych Open, 4(5): 401–03. https://www.drugsandalcohol.ie/30871/