Prison

Prison

Prisons are one of the most important settings to provide interventions aimed at drug users, both in terms of treatment and harm reduction.

What works?

  • Opioid substitution treatment has a very strong protective factor against death in prison for opioid-dependent prisoners. It is also very important that there is continuity of treatment in the community when drug users are released from prison
  • Substitution treatment is also particularly important in prison as it reduces injecting risk behaviours
  • Psychosocial treatments reduce the re-incarceration rates in female drug-using offenders
  • For drug-using offenders the use of naltrexone seems to help to reduce their re-incarceration rates
  • Education and training interventions with take-home naloxone provision help to decrease overdose-related deaths after release from prison
  • Therapeutic communities in prison may help to reduce re-incarceration rates of drug-using offenders with co-occurring mental illness

What's unclear?

  • It is unclear if pharmacological treatment in prison can help drug-using offenders to reduce use and criminal activity on release. This also appears the case for the specific sub-group of female drug-using offenders, yet caution is needed since the number of studies is small.
  • Moreover, it is unclear if the provision of needles and syringes in prison help prevent infections and reduce risky behaviours

What doesn't work?

  • So far, we are not aware of interventions which proved to cause harm

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