Substances

There were 49,881 adults receiving treatment for drug and alcohol problems in secure settings between April 2023 and March 2024. Most adults received structured treatment in prison (98%), including local, training, high security and open prisons. The remaining people received treatment in young offender institutions (over 1%) and immigration removal centres (less than 1%).

Opiates were the most reported drug by adults in treatment (47%) with 33% reporting both opiate and crack problems and 15% reporting problems with opiates but not crack. Eight per cent of people reported problems with crack but not opiates.

Over two-fifths (42%) of people said they had problems with alcohol, with just over a quarter (27%) of these people using alcohol only. Under a third (31%) of adults reported problems with cannabis and a quarter (25%) with powder cocaine.

Psychoactive substances (mainly synthetic cannabinoids, previously recorded as ‘new psychoactive substances’) were a problem for 6% of people in treatment in secure settings. However, this may not reflect overall psychoactive substance use in prisons.

Sex

Ninety-one per cent (45,433) of the people in treatment in adult secure settings were men. Nine per cent (4,448) were women, which is more than double the proportion of women in prison (4% at the end of March 2024).

Mental health

Over a quarter (28%) of people starting treatment were identified as having a mental health need. This proportion was consistent across the 4 substance groups (opiate, non-opiate only, non-opiate and alcohol, alcohol only), with the highest proportion in the non-opiate and alcohol group (30%) and the lowest (25%) in the alcohol only group.

Injecting

Most people starting treatment in 2023 to 2024 had never injected drugs (69%). This ranged from 49% of people in the opiate group to between 87% and 90% in the other substance groups. People in the opiate group were most likely to be currently injecting (14% compared to 1% or less for the other substance groups).

Continuity of care

We know from the evidence base that while prison drug and alcohol treatment can be effective; its effectiveness is mainly related to whether people continue in treatment on release. 

The proportion of adults released from prison and successfully starting community treatment within 3 weeks of release was 53% in 2023 to 2024. This is a 10 percentage point increase from the proportion reported in 2022 to 2023 (43%) and is 23 percentage points higher than when this data was first reported in 2015 to 2016 (30%).

Rates of successfully transferring from prison to community treatment varied around the regions of England. The North West had the highest rate of continuing treatment (66%) and London had the lowest (41%).

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