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Fewer people in prison drug & alcohol treatment
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The number of prisoners getting drug & alcohol treatment has fallen 12% in the last three years.

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Last week (30 January 2020), Public Health England published its annual Alcohol and drug treatment in secure settings 2018 to 2019: report.

The report contains information on both adults and young people in contact with treatment services in prisons and secure settings.

Numbers in treatment & substances used

There were 53,193 adults in alcohol and drug treatment in prisons and secure settings between 1 April 2018 and 31 March 2019. Around 65% (34,590) of these people also started treatment in the year. Of the people starting treatment, 50% said they had a problem with opiate use. Of the adults starting treatment with opiate problems, 75% also had a problem with crack cocaine.

Ninety percent of the people in treatment in adult secure settings were men and 10% were women. This is double the proportion of women in the total prison population (which was 5% at the end of March 2019. The substance groups showed large differences by sex. Three-quarters of women (75%) in treatment had problems with opiate use compared with half (50%) of men.

The median age of people in treatment for alcohol alone was 38 years. It was 37 years for those in treatment for opiate use (the corresponding figures for community treatment were 46 years and 41 years).

People in the non-opiate and alcohol and non-opiate only groups had median ages of 30 years and 28 years respectively (the median ages were 34 years and 30 years in community treatment).

Adults in alcohol and drug treatment in prisons tended to be younger than those in community-based treatment. Although, like community treatment, adults being treated for only alcohol problems or for opiates tended to be older than those treated for other substances.

demographics of prisoners in drug and alcohol treatment
Percentages of people in treatment in secure settings by main substance group 2017 to 2018


Almost all adults in treatment in secure settings (93%) in 2018 to 2019 received psychosocial interventions. Five percent received prescribing interventions only, and 2% either did not start an intervention or an intervention was not recorded. Almost half (49%) of adults in treatment received a prescribing intervention. There were 79% of the opiate group receiving these, 34% of the alcohol-only group and just 5% of the non-opiate group. Prescribing interventions are generally provided alongside a psychosocial component to help support a person’s recovery,

A total of 30,882 people left treatment in secure settings in 2018 to 2019. Just over a quarter (27%) of those were discharged after completing their treatment free of dependence. Adults in treatment for opiate problems had the lowest rate of successful completion (14%) compared to the other substance groups where the rate was 40% or higher.

Nearly two-thirds (64%) of adults leaving treatment were transferred for further treatment either in the community (45%) or in another secure setting (19%).

Continuity of care between treatment services in prisons and the community remains poor with just one third (34%) adults successfully starting community treatment within 3 weeks of release in 2018 to 2019.


The main two trends were a continued drop in the number of prisoners in treatment and a continued growth in the proportion of crack using prisoners in treatment. Detailed figures are provided below.

There was a 4% fall in adults in treatment in 2018 to 2019 compared with the previous year, continuing a year-on-year decrease that is now 12% lower than the first year these statistics were reported (2015 to 2016). Most of this decrease was in the non-opiate and alcohol group (6%) and alcohol-only (11%) group.

Thirty eight percent of people starting treatment in 2018 to 2019 reported problems with crack and opiate use. This has increased from 26% in 2015 to 2016. However, the proportion of people starting treatment for opiate problems without crack use has fallen year-on-year (from 22% in 2015 to 2016, to 13% in 2018 to 2019).

The proportion of people starting treatment for crack problems without opiates has gone up each year these statistics have been published (from 5% in 2015 to 2016 to 7% in 2018 to 2019).

Thanks to Andy Aitchison for kind permission to use the header image in this post. You can see Andy’s work here.

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