Identifying factors associated with drug use in prison – a quantitative survey among people in Belgian prisons

Background

People living in prison are more vulnerable compared to people in the general community. Scientific research indicates a higher prevalence of drug use, trauma and morbidity among people living in prison. Little information is available about the association of these factors in Belgium. As societal factors and drug policy might influence the associations within a specific country, this study aims to strengthen the existing evidence at national and international level. 

Methods

A cross-sectional survey was conducted in Belgian prisons between 2021 and 2022, as part of the European PRS-20 project. For each of the Belgian regions, at least one prison was selected. The survey was available in 13 languages. This quantitative study was part of a mixed method approach. Respondents reported on sociodemographic aspects, prison history, mental health and drug use. Associations between these variables are investigated based on illicit drug use within the current detention. Both bivariate and multivariate analyses was conducted.

Results

In total, 280 respondents participated to the study. The median age of the participants was 39 years old. Among the respondents, 85.7% reported to be male, 82.6% had a stable accommodation and 52.9% were employed before the current detention. The majority of the respondents had been in prison before (55.7%) and 50.2% was more than one year in prison at the moment of participation. In relation to the year before the current detention, 32.7% of the participants used illicit drugs. Within prison, 28.6% of the respondents reported illicit drug use. Among them, 48.2% initiated a different illicit drug in prison. During the current detention, 39% of the respondents became victim of violence, 60.2% experienced anxiety symptoms, 58.9% reported depressive symptoms, 9.5% attempted suicide and 41.9% indicated to have received mental health medication. Illicit drug use during the current detention was more prevalent (p<0.05) among male respondents, respondents who were previously at least twice in prison, respondents who were more than one year in prison, those who used illicit drugs before prison, those who became victim of physical or psychological violence, respondents who indicated symptoms of depression and those who have committed suicide in prison. Factors independently associated with increased odds (p<0.001) of drug use in prison include prison history, drug use the past year before detention and being a victim of physical violence in prison.

Conclusion

The current results identified static and dynamic factors associated to drug use in prison. Screening for drug use, trauma and psychiatric morbidity would allow identifying unmet needs and risks for using illicit drugs in prison. Consequently, this would facilitate appropriate treatment at reception into prison, while in custody and follow-up on release. Evidence-based interventions are likely to reduce psychological distress, recidivism and subsequent return to prison.