Drug users in European prisons: a population with specific healthcare needs
On a given day, there are more than 600 000 people in prison in the European Union. Prison population rates vary greatly between countries. Levels of prevalence of drug use and drug-related problems are substantially higher among prisoners than among the population in the community. The current EU drugs strategy puts emphasis on ensuring that the care received by drug users in penal institutions is equivalent to that provided by health services in the community.
The last available data on prevalence of drug use and expert ratings on the availability and level of provision of selected drug interventions for drug users in prison were collected by the EMCDDA national focal points in EU Member States, Turkey and Norway, and supplemented with information from literature reviews. It should be noted that data on drug use in prisons often come from heterogeneous ad hoc studies, which makes it difficult to draw comparisons.
Most studies carried out in prisons in the last ten years indicate that about 50 % of prisoners have ever used an illicit drug in their life. However, this can vary greatly by country. On entering prison, most drug users cut back or stop using drugs or change to using other substances. While the majority of those who report illicit drug use in prison have started elsewhere, some do so in prison, and others switch to more harmful methods of drug taking, such as injecting.
Drug-use-related treatment services include detoxification, counselling and short and long-term treatment. Despite the availability of some specific drug interventions, the level of coverage varies between prisons and may be limited. All countries but one reported available opioid substitution treatment (OST) in prison, although the coverage is still limited.
Drug users make up a substantial proportion of the prison population in most European countries and a large overlap exists between prison and problem drug use populations. Many problem drug users, who do not have contact with services in the community, can be reached by drug treatment services when in prison. Compared to the early 2000s, the availability and levels of provision of health and social care services targeting the needs of drug users in prison have improved in several European countries.