Problematic drug use in prison remains a pervasive and increasing concern throughout the European Union (EU) in terms of costs to the individual, community and the state…
Problematic drug use in prison remains a pervasive and increasing concern throughout the European Union (EU) in terms of costs to the individual, community and the state. Drug‐related problems in prison seem to be more prominent among female prisoners, as a high proportion of them are problematic drug users whose use continues in prison. Assuming that women’s drug use is an indication of need for treatment and health care, it becomes increasingly interesting how the European penal institutions differ in their response to this need. For this reason, a survey of the prison drug services for adult female drug users has been carried out among the Ministries of Justice of all 25 EU member states. The main purpose of the survey was to gain comprehensive and systematic information on the prevalence of female problematic drug users in European prisons and the availability of treatment and healthcare services. Altogether, 27 European countries and autonomous regions completed the questionnaire developed for this survey. The results of the data analyses indicate that there is poor availability and quality of data relating to the extent of problematic drug use in women’s prisons and, where it is available, it seems to underestimate the proportion of female problematic drug users in prisons. However, most of the European countries provide a range of different harm‐reduction and drug treatment services to respond to the reported health and rehabilitation problems of female problematic drug users. At the same time, however, it is evident that there is a need for further action in some countries, due to their low provision of prison drug treatment and healthcare services for this group. This article is based upon the European research project ‘Female drug users in European prisons’, which was conducted between 2003 and 2004 and funded by the AGIS Programme, Directorate General Justice and Home Affairs, of the European Commission.
This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to…
This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non‐binding or so‐called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.
This chapter reconstructs and critically examines the recent history of strip searches in Belgium. About 10 years ago the Belgian parliament adopted its first law on…
This chapter reconstructs and critically examines the recent history of strip searches in Belgium. About 10 years ago the Belgian parliament adopted its first law on prisoners’ rights. A major part of the Prison Act of 12 January 2005 deals with disciplinary and control measures. Article 108, in particular, has provoked quite some controversy. It introduced a clear distinction between the (more superficial) search of an inmates’ clothes on the one hand, and the (substantially more intrusive) measure of strip searching on the other hand. The main difference between these two measures is that the latter involves forcing prisoners to strip naked. Because of their intrinsic intrusiveness, such strip searches were meant to be exceptional measures: they should only take place following an individual assessment and decision by the prison governor. In practice, however, the prison administration tended to interpret Article 108 somewhat differently and the line between searching an inmate’s clothes on the one hand and strip searching on the other became blurred.
I first discuss the problem of order in prisons and explore how strip searches have been regulated in Europe. I then reconstruct the recent history of the regulation of strip searches in Belgium. In order to make sense of this history, I mobilize some of the ideas of Stanley Cohen’s sociology of denial, in particular, his distinction between literal, implicatory and interpretive denial, and apply these to the history of strip searches in Belgium.
A consistent finding from this chapter is that the Belgian prison administration has – through creative manoeuvres of interpretive denial – been able to circumvent the new barriers that were erected by the Prison Act of 12 January 2005 and, in doing so, it has been able to continue stripping detainees naked without an individualized decision from the prison governor. The approach that I develop throughout this chapter helps us better appreciate the limits of legal reform and top-down (European) regulation of strip searches.
The chapter demonstrates that Stanley Cohen’s work on denial is not only useful for scholars who do research on gross human rights violations but also for interpreting more down-to-earth aspects of criminal justice systems across the globe.
Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine…
Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine Type Stimulant (ATS) users in prison in nine European countries. Methodology. Across nine European member states (Belgium, the Netherlands, Czech Republic, Lithuania, Slovenia, Sweden, Malta, Ireland and Portugal), interviews were conducted with ministerial representatives and professionals (i.e. service providers and security officials) working in prisons and a total of 16 focus groups with a total of 125 prisoners. Results. The use of stimulants in prison is associated with aggression and violence, financial problems, and psychological and physical problems in prisoners (depression, anxiety and psychological craving). Both security and healthcare staff in prison often feel ill‐equipped to deal with stimulant‐related problems, leading to a lack of equivalence of care for stimulant users in prison, therefore the variety and quality of drug services outside is not reflected sufficiently inside prison. There is a need for more specific product information and harm reduction material on stimulants, for clear guidelines for the management of acute stimulant intoxication and stimulant withdrawal, for structural adjustments to improve potential diagnosis of personality and psychiatric disorders, for more non‐pharmacological treatment strategies and more opportunities for prisoners to engage in purposeful activities.
The objective of this study was to examine practices and policies in place for the provision of substitution treatment in prison in 18 European countries. Methodology…
The objective of this study was to examine practices and policies in place for the provision of substitution treatment in prison in 18 European countries. Methodology. Across the 15 European member states (prior to 1 May 2004) and Czech Republic, Poland and Slovenia, interviews with ministerial representatives, professionals (i.e. service providers and security officials) working in prisons, and a total of 33 focus groups with a total of 132 male and 52 female prisoners were conducted. Results. Although constraints of access to substitution treatment for specific target groups only (e.g. HIV‐positive opiate users) have largely vanished, substitution treatment is now offered to a broad cross‐section of prisoners. The provision of this treatment still lags behind the standards of substitution treatment in the community (regarding access and continuity). In most countries, this form of therapy is most likely to be discontinued when entering prison. A treatment gap persists between prisoners requiring substitution maintenance treatment and those receiving it. Heterogeneous and inconsistent regulations and treatment modalities appear throughout Europe, sometimes within the same country or region. The concrete provision practice of substitution treatment in prison varies from one country to the other, from one prison to the other, within a medical team, and even from one doctor to another. Although psychosocial care was seen as a valuable additional and necessary part of the treatment to support the medical part of the substitution treatment in prison, it was found that such support was rarely provided. Compared to previous research, this study illustrates that the scope of substitution treatment has extended considerably across Europe. Across the board, a consensus surrounding the need to continue substitution treatment that had already been started in the community was apparent.
The strongest international recognition of the importance of women’s health in prisons and the urgentneed for radical change was highlighted of a WHO Conference held…
The strongest international recognition of the importance of women’s health in prisons and the urgent need for radical change was highlighted of a WHO Conference held recently in Kiev, Ukraine.
The purpose of this paper is to analyse the extent of throughcare provision for prisoners with problematic drug use. Effective throughcare services have been recognised as…
The purpose of this paper is to analyse the extent of throughcare provision for prisoners with problematic drug use. Effective throughcare services have been recognised as important because they help to ensure that any progress in treatment made in prison is continued on release. Previous research demonstrates that examples of good practice in throughcare provision for prisoners with problematic drug use exist in many parts of the world. However, evidence from recent work carried out in Europe indicates that the implementation of throughcare services for this group of prisoners is limited and ineffective in some EU member states. This paper aims to explore the reasons for such failure and to identify the barriers to implementing effective throughcare for this particular group of prisoners.
This paper is drawn from research carried out as part of a European project funded by the Directorate General Justice of the European Commission. The project involved six partners from a range of different member states. The research involved a literature review, followed by in‐depth interviews and focus groups with key stakeholders. Each partner carried out the qualitative research within their own country, in order to enable the team to capture local nuances.
The findings indicate that key barriers to implementation of effective throughcare are resources which impacts on the availability of support services, attitudes and training of staff and ultimately the continuity of care.
This paper adds to the body of knowledge regarding the provision of effective throughcare to those with problematic drug use.
The article will discuss the particular needs of women prisoners, many of which are replicated in prisons throughout Europe, and are also often undetected and…
The article will discuss the particular needs of women prisoners, many of which are replicated in prisons throughout Europe, and are also often undetected and underestimated. The focus will be on the situation for women in Italian prisons, considering the specific health and social care needs they present, how some needs differ to those of male prisoners, and to what extent the organisation of prison health attempts to meet these needs. The key issue identified is that the organisation of prison health deals predominantly with emergency cases and is not able to provide a preventative healthcare service to women in prison. Also, women prisoners suffer a greater impact on their physical and mental well‐being as a result of poor implementation of healthcare services, as well as from the regime of prison itself.
Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment…
Health care practitioners in prison face the challenge of providing high standards of health care within the unique peculiarities and restraints of the prison environment. The strict adherence to principles of medical ethics by the prison health care staff and the knowledge and acceptance of these principles by the whole prison community not only results in ethical conduct but also yields practical professional advantages such as guidance in situations of conflict, promotion of confidence and avoidance of misunderstandings. The internationally consented conventions, declarations and recommendations relevant on medical ethics in prison are presented and their basic principles ‐ the primary task of the prison doctor, access to a doctor, equivalence of care, patient’s consent and confidentiality, preventive health care, humanitarian assistance, professional independence, professional competence ‐ are discussed. In addition, the personal obligation of the prison doctor for ethical reflection and decision making in individual ethical issues not covered by the quoted documents and in ethically controversial issues is emphasized. A training course and published guidelines for ethical conduct in prison health care are recommended.
Since the early 1990s, various countries have introduced HIV prevention programmes in prisons. Such programmes include education on HIV/AIDS, HCV and on drug use for…
Since the early 1990s, various countries have introduced HIV prevention programmes in prisons. Such programmes include education on HIV/AIDS, HCV and on drug use for prisoners and for staff, voluntary testing and counselling, the distribution of condoms, bleach, and needles and syringes, and substitution therapy for injecting drug users. Other forms of drug‐dependence treatment, as well as drug demand reduction and drug supply reduction measures may also be relevant to managing HIV/AIDS and HCV in prisons, and may facilitate HIV prevention measures ‐ or have unintended negative consequences for such measures. Prison systems in a growing number of countries are implementing such programmes. However, many of them are small in scale and restricted to a few prisons. Provision of care and treatment for people living with HIV or AIDS has become a priority worldwide, and it is considered to be a basic human right. This includes the provision of antiretroviral therapy (ARV) in the context of comprehensive HIV/AIDS care. Providing access to ARV for those in need in the context of correctional facilities is a challenge, but it is necessary and feasible. Studies have documented that, when provided with care and access to medications, prisoners respond well to ARV. Part 3 of the select annotated bibliography on HIV/AIDS and HCV in prisons contains selected “essential” articles and reports that provide information about (1) substitution treatment and other forms of drug‐dependence treatment; (2) other drug demand and drug supply reduction measures; and (3) care, treatment, and support for prisoners living with HIVor AIDS and/or HCV. Each section also contains a brief review of the evidence, based on recent work undertaken by the World Health Organization (WHO).