Drugs in Prisons
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Drug Summit 2024: Uniting Church Comments
Overview
Australia has about 43,000 people in prisons many of whom enter prison having poorer physical and mental health in comparison to the general population (1). Furthermore, a large proportion of these prisoners have a history of alcohol, drug use and dependence in addition to co-occurring mental illnesses.
Individuals in prisons often report having experienced social exclusion, disadvantage and trauma before being imprisoned. They have higher rates of housing instability, homelessness, unemployment, mental health issues, chronic physical diseases such as diabetes, cancer, asthma and arthritis and communicable diseases such as hepatitis. These factors increase the risk of drinking, drug use and dependence.
Australia’s alcohol and drug services reach less than half of those who need treatment – and these rates are even lower for people in the criminal justice system (2).
Illicit and Injection Drug Use in Prison
Drug-related health risks for people entering and leaving prisons are significant. While some people end up in prison for reasons related to their drug use, others may start their drug use in prison (3). Approximately 65% of people entering prisons have reported having used illicit drugs in the past year (4). Some of the common drugs include methamphetamine, cannabis, painkillers and sleeping pills.
There is also an overrepresentation of individuals who administer drugs through the use of injections in the justice system (5). Half of the prison population in Australia have injected drugs at some point in their lifetime and two thirds of them have done so in the past year. Furthermore, one in five have reported sharing injecting equipment while in prisons which increase their risk of contracting hepatitis B and C.
Mental Health, Self-harm and Suicide in Prison
Many people in prison have both a mental health condition and substance use disorder (6). Approximately 40% of them enter prisons with a diagnosed mental health disorder and many more have gone undiagnosed and untreated.
People entering prison are also more likely to have a history of self-harm and suicidal thoughts. 44% of individuals in prison have reported having a history of suicidal thoughts with 21% of them having attempted suicide at some point in their lifetime. Additionally, approximately half of those who die from suicide in prison have had a history of self-harm. Therefore, prisoners are at risk of self-harm and suicide upon release.
Because most of them will not seek help for their mental health, self-harm or drug dependence issues upon release, prisons should provide them with opportunities to participate in health and support interventions in addition to identifying individuals with mental health and drug use issues and providing them the treatment they require to aid in rehabilitation upon release.
Treatments in Prisons
People receiving treatment or medication before going to prison don’t always have access to these supports once they are imprisoned which can leave them waiting for medication and lead to issues such as withdrawal or mental health instability.
Furthermore, due to the 56% increase in people entering prisons in the past 10 years, prisons are often over-capacity. As such, people are sometimes moved from one prison to another, making it difficult to provide treatment and continuous care.
Treatment options differ between each state and territory and national programs such as Medicare or the Pharmaceutical Benefit Scheme (PBS) often aren’t available which can be problematic for someone receiving alcohol and other drug treatment.
Of prisoners who have been released, 13% of them accessed Alcohol and Other Drug (AOD) treatments while in prison. This lack of access to health care and AOD treatments increase their risk of overdosing, self-harming, suicide and poorer health outcomes.
Improving Post-Release Care
To help prevent the cycle of imprisonment, better support is needed for people while they’re in prison and once they have been released. This includes improved health care, secure housing, education and employment. Currently, 50% of people leaving prison expect to be homeless once released.
People who have managed to stop their AOD use in prison will often use it again once released and are also at high risk of overdose – particularly in the first few weeks following release.
Furthermore, approximately 42% of people leaving prison will reoffend and be reimprisoned within six-months of release. Some factors that increase one’s risk of reoffending include homelessness, inadequate social support, unemployment, chronic health problems and most importantly, having a history of substance dependence.