Understanding Drug Use in a Dutch Prison: A Call for Improved Research and Care and Lessons learned

Understanding Drug Use in Dutch Prisons: A Call for Improved Research and Care and Lessons learned  
Background 
Despite being recommended by the EMCDDA and prioritised in the current EU Drugs Strategy (2021-2025), in the Netherlands, research in Dutch prisons on drug use and available care and support for detainees who use drugs not been conducted in recent years.  
Understanding current drug use among people incarcerated in Dutch prisons is essential. In response, Correlation – European Harm Reduction Network (C-EHRN) and Trimbos Institute conducted an exploratory study in late 2022. The study, funded by the Ministry of Health, Welfare and Sport, investigated drug use in Ter Apel prison. 
Methods 
A mixed method was used: questionnaire among employees and among inmates, follow up in-depth interviews with prison stakeholders, and the use of additional information provided by the prison administration. 166 employees filled in a complete questionnaire, the detainee questionnaire was responded by 69 detainees, and additionally 13 in-dept interviews were conducted. Finally, we analysed additional data from urine checks and from substances encountered in the prison. 
Results 
Drugs are used in the Ter Apel PI. Besides cannabis and alcohol, there appears to be significant use of synthetic cannabinoids (SCRAs) and inappropriate use of medication dispensed in the prison. 
Surveys and interviews indicate that drug use in the prison does not cause major disruptions to daily operations or have a major impact on work. Health incidents following drug use were not reported in 2022. 
The available care offer does not seem to be well known among both staff and detainees. In contrast, the care offered seems relatively low threshold, but there are barriers in the form of a language or cultural barrier. No addiction care is offered in the prison. 
There is a lack of knowledge among staff about drugs, their effects and possible risks for almost all substances, possibly with the exception of alcohol and cannabis. There seems to be a need for knowledge on SCRAs and other (new) substances. 
Conclusions and recommendations 
The researchers conclude that is it essential for the Ter Apel prison and the Ministry of Justice and Security to – amongst other things-: 
1.. Expand this pilot study to other PIs in the Netherlands 
2. Design and conduct a qualitative survey among detainees to gain a thorough understanding of current drug use in PI Ter Apel; 
3.Commit to reducing demand for SCRAs 
4. Offer additional drug-related care and services for detainees. 
5. Initiate investigations into inappropriate and potentially large-scale use of medication dispensed in the PI and importation of this medication. 
6. Set up a system for structural monitoring of drug use and health incidents in the PI which facilitates timely policy adjustments. 
 
*EQDP/EMCDDA group 
* European drug monitoring in prison