Safer Prescribing in Prisons was first published in 2011 by members of the Royal College of General Practitioners Secure Environments Group (RCGP SEG). The first edition was well received by prescribers and was one of the first publications to identify how widely and easily prescribed medicines could be misused. The relevance of this problem is now universally accepted as unprecedented levels of addiction to prescription medicines have become evident across Western society. RCGP SEG was one of the first organisations to identify the widespread misuse of pregabalin as a result of the direct day-to-day experience of its members as prescribers in the health and justice system.

This second edition is written to improve our knowledge and to provide practical support to clinicians working in prisons. It also has relevance for clinicians working in other secure environments and in the community. NHS England (NHSE) has supported this second edition recognising the importance of prescribing workstreams. This edition will be of use to prescribers working in the community whose patients spend time in custody, when a patient is expecting a custodial sentence and when patients leave prison and return to general practice. Community clinicians should be aware of important prescribing issues which are relevant in the prison system and recognise the importance of the prescribing decisions that they make which could affect treatment when a patient enters custody. Rationalisation of a patient’s care before detention may help the transition into custody and the care provided by the prison healthcare team. Other clinicians who may find this guidance a useful reference include forensic physicians and custody nurses; consultant psychiatrists; nonmedical prescribers; pain clinic specialists and hospital clinicians.