Transcript Prisoners’ drug use pre-prison

Drug treatment in prisons:
recent evidence
Jessica Harris, RDS NOMS, Home Office
Malcolm Ramsay, DSPD Programme, Home Office.
Structure of the presentation:
 The need for treatment – prisoners’ drug
use pre-prison, in prison and after prison
 What’s available and what works?
 Current issues and evaluation plans.
Prisoners’ drug use pre-prison
 69% tested positive for one or more illicit
drug;
 36% tested positive for two or more;
 31% tested positive for opiates;
 22% tested positive for cocaine;
 38% tested positive for either or both;
High probability of testing positive for:
females, 20-29 year olds, white arrestees,
property offences.
[NEW–ADAM programme, 2004 ]
 At least 93% prisoners had used drugs in
the 30 days before custody;
 62% heroin, 49% crack and 42% cannabis
 74% took two or more different drugs
 Heroin: 46% white prisoners, 16% black;
 Crack: 8% white prisoners, 30% black;
 Average spend of £600 a week on drugs.
[CARATs assessment, 2004/05]
Offending
 Criminality Survey 2000: money to buy drugs most
commonly cited reason for offending;
 (55%) reported that they had committed offences
connected to their drug taking;
 CARATs: theft and handling (24%), burglary (17%),
drug offence (11%);
 NEW-ADAM: 75% of arrestees committing one or more
acquisitive crime in the last 12 months had used
heroin and/or cocaine and/or crack.
Prisoners’ drug use in prison
 MDT Survey: About 16% prisoners reported
using drugs in week before interview;
 Cannabis and opiates (usually heroin) most
commonly used;
 0.7% prisoners had initiated/resumed heroin
use, having used no illicit drugs in the year
prior to custody;
 Criminality Survey: Only half of pre-prison
drug users reported continuing to use drugs in
prison.
 Use of stimulants (cocaine/crack) relatively
uncommon in prison.
 Levels of re-offending post-release were
significantly higher for drug users (62%) than
for abstainers (36%).
 Heroin is the white offender’s drug of choice?
 Crack is the black offender’s drug of choice?
Drug use was particularly widespread among:
 short-term prisoners;
 property offenders;
 white prisoners.
[Source: ‘Tackling Prison Drug Markets: An exploratory Qualitative Study’
2005]
Prisoners’ drug use after prison
 In the week following release, prisoners were
about 40 times more likely to die than a
member of the general population;
 male prisoners were about 29 times and female
prisoners 69 times more likely to die;
 immediately post-release, over 90% of deaths
were associated with drug related causes;
 deaths from drug use post-release reflect
lowered levels of tolerance.
[Source: ‘Drug-related mortality among newly released offenders’
2003]
 Opiates were involved in almost all (97%) drug
related deaths;
 just over half of deaths were recorded as
involving only one drug;
 mortality rates for women were generally higher
than those for men;
 Prisoners aged 25 to 39 at the time of release
were most at risk;
 odds of drug-related deaths higher for ‘white’
prisoners than for those in other ethnic groups.
Risk factors for drug mortality include:
 separated, divorced or widowed;
 had used drugs in the month before entry into
prison;
 had not used drugs in prison.
[Source: Office of National Statistics,1997]
What treatment is there and what
works?
 Detoxification
 CARATs
 Intensive treatment programmes
– (Cognitive behaviour, therapeutic
communities,’12-step’ programmes and
methadone provision).
White women:
 higher dependency rates than black women (60%)
 more likely dependent on heroin (a ‘depressant’)
Black/ mixed race women:
 Lower dependency rates (29%) than white women
 More likely dependent on crack (a ‘stimulant’)
[Source: The ‘treatment needs of white and black/mixed-race female
prisoners’ 2003]
Some obvious needs…
 to continue to develop the prison drug strategy
in a way that brings together treatment and
security;
 to increase provision for crack and poly-drug
users;
 to make further efforts to reach short-term
prisoners.
What now? Current issues and
evaluation plans
 Data - much is out–of–date;
 Continuity of care – currently difficult to link
prison data to community data;
 More research needed on the impact of
interventions in reducing reoffending;
 Effectiveness of methadone versus
detoxification;
 Evaluation of IDTS – enhanced CARATs.