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Substance use in prisons

HMPPS research explores the wider cultural features of prisons which impact on levels of drug use.

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Case study of five closed male prisons

On Wednesday (28 October 2020), HMPPS published new research on drug use in prison. The study: Exploring Substance Misuse in Prison: A case study approach in five closed male English prisons is written by Dr Helen Wakeling of HMPPS and Kieran Lynch of Public Health England.  

The aim was to explore the wider cultural features of the prisons which, according to the recovery literature, may have an impact on levels of drug use, and has not been investigated in prior research. Observations, interviews, documentation analysis and data gathering were carried out. A total of 78 staff members and 61 residents across the five prisons were interviewed. Nine themes emerged from the qualitative analyses, which were clustered into three domains. 

The scale and nature of drug use in prisons

The first domain was entitled ‘descriptions of drug use’ comprising themes which described the extent and consequences of drug use. This included a theme around the ‘epidemic’ nature of drug use, which encapsulated the perceptions that the extent of substance use was widespread, had major impacts on the prison, staff and residents, and was akin to an epidemic in prisons. Psychoactive substances were the most problematic drug reported. Also identified was a theme around the reasons for drug use, entitled ‘escapism’, to reflect the most commonly cited reason for drug use across the five prisons, as well as a theme entitled ‘prison type and population’, which grouped together perceptions of different contextual factors which impact on drug use, including the specifics of the population held at the prison, the prison type, the regime and staffing levels. 


The second domain was ‘rehabilitative focus’, and contained three themes: relationships, hope and prison culture. Relationships between staff and residents, and within staffing groups were perceived as fundamental, and differed between prisons with higher levels of substance use and those with lower levels of substance use. In prisons with a more prominent drug problem and amongst those who reported using drugs, there was a real sense of hopelessness and helplessness amongst both staff and residents. The culture of the prisons also seemed to be related to substance use, with more punitive cultures existing in the prisons with greater levels of substance use. 


A bottle of Methadone mixture stands on the window sill in front of the bars in the  prison pharmacy.
© Andy Aitchison

Tackling drug use in prison

The third domain was called ‘enablers of a more effective response to drug use’ and included themes around resources (e.g. staff numbers and time), treatment provision, and prison regime/activity, all of which were factors which could help better address substance use. Resourcing was perceived to be key in dealing with the issue of drug use in prisons. Particularly in prisons with higher levels of drug use, many staff said that they did not have the time to devote to meaningful activity with residents, being instead overrun with paperwork, and managing processes and the consequences of drug use. There was limited treatment provision for substance use across all five prisons, and services were often observed to be quite separate from the rest of the prison rather than an integral part. The provision and availability of purposeful activity and a full regime were deemed important to support the reduction of substance use in prisons.


Recommendations arising from this predominantly qualitative analysis included recognising the extent of drug use, the need to focus on ‘recovery capital’, and adopting a prison wide approach. Improving and strengthening staff and residents’ relationships, a greater use of rehabilitation over a solely punitive stance, better training for staff, a focus on improving procedural justice, and improving communication between staffing groups regarding Substance Misuse Services and healthcare services were also recommended.


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

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