Prisons are one of the most important settings to provide interventions aimed at drug users, both in terms of treatment and harm reduction.
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
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
Best practice is the best application of available evidence to current activities in the drugs field.
underlying evidence should be relevant to the problems and issues affecting those involved (professionals, policymakers, drug users, their families);
methods should be transparent, reliable and transferable and all appropriate evidence should be considered in the classification process;
experience in implementation, adaptation and training should be systematically collected and made available;
contextual factors should be studied by modelling different prevalence levels so as to assess the impact of an intervention on the population; and
evidence of effectiveness and feasibility of implementation should both be considered for the broader decision-making process.
This definition was agreed by a group of experts including the Chairman of the EMCDDA Management Board João Goulão; members of the EMCDDA Scientific Committee; policymakers and top-level researchers in the areas of treatment, prevention and harm reduction.
Best practice portal
The Best practice portal is a resource for professionals, policymakers and researchers in the drugs field. We provide information on the available evidence on drug-related prevention, treatment and harm reduction, focusing on the European context. The evidence is compiled following an explicit methodological process, and is presented according to client profiles. The client profiles are designed according to the European data on illicit drug users collected at the EMCDDA. Currently, the profiles are organised around the main substance of use. We acknowledge that in reality people often use multiple drugs and the interventions provided might reflect this. We are therefore working on how best to accommodate this aspect in the future. In the portal we also provide an overview of the available quality standards and guidelines in the European Union (EU) Member States.
The portal was developed to respond to the EU drugs action plan (2009–12) and specifically to ‘enhance the quality and effectiveness of drug demand reduction activities, taking account of specific needs of drug users according to gender’. In particular, actions 17 and 19 aimed at exchanging ‘good practice guidelines/quality standards for prevention, treatment, harm reduction and rehabilitation interventions and services’ and ‘to develop an EU consensus on minimum quality standards and benchmarks for prevention, treatment, harm reduction and rehabilitation’.
The portal will be continuously updated as information and research on interventions emerges.
Peer Van der Kreeft
Collaborations and patnerships with external organisations
Below are some of the ongoing collaborations and partnerships involving the EMCDDA's Best practice portal and external organisations.