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| |  Substance Use In Prisoners The Norm Rather Than The Exception LONDON -- July 4, 1997 -- Prison reception health screening consistently underestimates drug and alcohol use, and a positive finding should be considered the norm rather than the exception, says a paper in this week's British Medical Journal (BMJ). The authors studied 548 adult men awaiting trial in Durham prison, and found that, before remand, 57 percent were using illicit drugs, 33 percent had problems of drug dependence, and 32 percent had drink problems. Seventy-one percent were judged to require help for their drug or alcohol use and 36 percent were assessed as needing a detoxification programme. Prison reception health screening for the same problem produced consistently lower figures, and fail to identify the extent to which substances are used and misused by people newly remanded to prison, say the authors. Provision of detoxification programmes for those prisoners who were identified at reception screening as having serious drug and alcohol problems were inadequate, they say; of 113 men needing a course of tranquillisers to ease withdrawal from drugs or alcohol, only six received one. Prisoners who need help but think that asking for it is more likely to result in punishment than treatment are not likely to be truthful about their substance abuse, say the authors. "More consideration needs to be given to reducing substance abuse in prisons by improving assessment at reception and providing better treatment for misusers rather than using random urine screening to detect and punish offenders", they conclude. Prevalence of HIV and injecting drug use in Liverpool prison Another paper in this week’s BMJ concludes that prisons represent a valuable opportunity to educate drug users, familiarising them with safe injecting practices and the range of health services available, if not when incarcerated then certainly on release. Of 219 new arrivals at HM Prison, Liverpool, who had a history of drug use, only 36 had ever injected in prison. Though this suggests that prison reduces injecting behaviour, say the authors, for those who continue to inject while incarcerated levels of risk behaviour are substantially increased. The frequent exchange of subjects between the local injecting community and the prison population means that drug use in prison cannot be taken in isolation, they say.
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