PRS20: drug use and perceived mental health concerns among people living in prison in the Grand-Duchy of Luxembourg

Compared to the general population, people living in prison are particularly vulnerable, and more frequently experience health problems such as non-communicable diseases, infectious diseases, cognitive impairment, and excessive drug use. PRS20 is a European project among five European countries which aims to gain a better understanding of drug use in prisons, as well as perceived mental health, and the views and needs of prisoners with regard to treatment and harm reduction services. This study describes the findings of its implementation in Luxembourg.

A non-probability, purposive sampling method (convenience sample based on self-designation) was used to recruit the people living in the closed prison setting in Luxembourg. An anonymous self-administered paper-pencil questionnaire was distributed in July 2022  assessing drug use, mental health, service use and experiences and needs in coping with addiction and related consequences. Only people aged 18 or above living in the prison during the data collection period were eligible. People living in prison in isolation or COVID-19 quarantine were excluded, as well as those with cognitive impairments. Statistical analyses were conducted using IBM SPSS Statistics 25. Advanced analyses will identify the determinants of drug use inside prison, and the relations between substance use and mental health conditions (results not yet available).

Data from 193 valid questionnaires were included in the analysis (35% of the prison population). Preliminary results show that a high proportion of participants indicated using drugs prior to imprisonment (73.9%), as well as during the current imprisonment (36.2%). The prevalence (ever use) of non-prescribed sedatives and tranquilizers in prison is high, since they are the second most prevalent psychoactive substance in prison (15.5%) after cannabis, whereas they rank sixth outside prison (22.8%). Moreover, among lifetime substance users, cannabis and non-prescribed sedatives or tranquilizers are among the substances with the highest prevalence of initiation of use in prison (cannabis: 35.0%; sedatives or tranquilizers: 43.5%). Of the participants who reported having used drugs, 89.0% reported suffering from symptoms of depression or anxiety in the last two weeks, with a high prevalence of comorbidity between depression and anxiety (78.9%). People living in prison currently using drugs also reported more feelings of insecurity and loneliness compared to those with no current use. 

This study confirms the reality and extent of drug use in prisons. It shows a high prevalence of mental health disorders among people living in prison, particularly among current drug users. While a vast number of services related to substance use or mental health are available, people living in prison are reluctant to use them. Future efforts should account for the frequent comorbidity between drug use and psychological suffering. * EQDP/EMCDDA group /*European drug monitoring in prison