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Prisoners have a high level of drug use prior to imprisonment. Many inmates report having injected drugs and using cannabis. Prison authorities employed a range of strategies to detect drugs and drug use in prison. However, it was unclear which supply reduction strategies operated, and the prevalence and types of drugs detected in Australian prisons. The purpose of this paper is to examine supply reduction strategies in Australian prisons. Information on searches for drugs, and from inmate urinalysis was collected. The study focussed on adults in fulltime custody in Australia in 2009.

A representative of all corrective services departments and justice health services was asked to complete a questionnaire on supply reduction strategies, including searches for drugs and drug testing of inmates.

The two main supply reduction strategies identified in all Australian prisons were the use of drug detection dogs and urinalysis programs. Despite an extensive use of drug searches and urinalysis, the detection of drugs was modest for both strategies. The most commonly used drug was cannabis with the detection of drugs such as amphetamines and heroin being very low.

Prison inmates have a history of high levels of drug use prior to imprisonment. However, the supply reduction measures of drug detection dogs and urinalysis indicate that drug use was low in Australian prisons.

The paper recommends that urinalysis comprises targeting testing regimes and that random testing ceases in order to be a more cost effective use of resources for drug detection.

The study is the first report on the range of supply reduction measures in Australian prisons and, possibly in the world. Both measures were employed extensively across the country and finds of drugs and drug use were relatively low. Two possible conclusions can be drawn; that either drug use was very low in prison or that it was well concealed from the authorities. A comparison of random testing with targeted testing of inmates, where the former yields fewer positive results shows drug use was likely to be low rather than well concealed.

In Kyrgyzstan the prevalence of injecting drug behaviour is among the highest found throughout the world. Health promotion training, improved health care and needle/syringe exchange (NSE) programmes have been shown to decrease risk behaviour among injecting drug users. In Kyrgyzstan, an intervention study with training of prison staff and prisoners was performed in one prison. Before and after the training, a random selection of the prisoners answered a questionnaire about drug use, risk behaviour and health care. The survey was carried out in both the intervention prison and in a reference prison. The number of drug users, the use of drugs and risk behaviour were improved significantly within half a year and, especially, the injection and use of drugs decreased in the intervention group. The study clearly shows that increased focus, improved healthcare and training of prisoners and staff on drug use and harm reduction can reduce both use of drugs and risk behaviour.

Drug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso.

We conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata.

A total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91–8.41])} higher odds to use drug in prison.

To conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners.

The actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison.

Most of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release.

To the best of the authors’ knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

While steroid use in the sports context has already been extensively studied by academic researchers, its patterns and implications in the prison context have received scant attention. Why do inmates use androgenic–anabolic steroids (AAS)? How does this use relate to sports activities, in particular fitness training, and what does it mean vis-à-vis the body image that is promoted in this environment? Does it even relate to fitness or sport? How do prison authorities regulate or prevent prisoners' AAS use? This empirical study is based on 28 interviews with 19 inmates and nine staff members (guards, managers) of four Belgian prisons. We showed that steroid use is largely connected with fitness activities and that it has an instrumental, goal-oriented dimension. AAS are used for athletic/performance purposes, e.g. increasing muscular strength. They also help gain or maintain a satisfactory body (self-)image, which has implications on the own identity, prestige and power relations within the prison community. In jail, the body is a major type of symbolic capital that is intended to reinforce status and cope with the difficulties and actual conditions of incarceration. We also observed differences in the perceived legitimacy of the various drugs that are used in prison. While guards are more tolerant towards AAS than other drugs, prisoners are less prone to openly confess to using AAS. Admitting to using AAS would damage the inmate's reputation, the legitimacy of his muscled body, and the subsequent goals of individual power and prestige.

Aim ‐ To describe prescription drug use in a nationwide prison population and compare it with contemporary drug use in other relevant populations as well as in a prison population 25 years ago. Method ‐ Detailed medication sheets from 37 prisons, covering 90% of the Norwegian prison population, were collected. All drugs were transcribed into the Anatomical Therapeutic Chemical classification system, and Defined Daily Doses/100 inmates were calculated. Data enabling relevant comparisons were gathered from reliable sources. Results ‐ Among the 2,617 inmates investigated, 48% used no medication. Sixteen percent used both psychotropic and somatic drugs, 17% psychotropic drugs only, and 19% somatic drugs only. Strong correlations between drug use and gender, age, and prison characteristics were demonstrated. Psychotropic drug use was higher than in the general population but lower than in a psychiatric hospital unit. Somatic drug use was lower than in the general population, except non‐steroid antiinflammatory agents, antihistamines, and drugs to alleviate obstructive airway diseases. Psychotropic drug use, particularly antidepressant use, was higher than in prisons 25 years ago. Conclusion ‐ High levels of use of all psychotropic and a number of somatic drugs were demonstrated in this nationwide prison population. Treatment studies are needed in order to ascertain whether the high levels of use of particularly psychotropic medications are indeed improving the mental health of prisoners.

The United Kingdom Ministry of Justice recently highlighted the extent of buprenorphine (Subutex) misuse in English andWelsh prisons, naming it the third most misused drug overall. Yet little is known regarding how illicit buprenorphine is obtained in prison and what influences prisoners to use it. Qualitative research was used to explore prison drug using practices. Thirty men who were former prisoners with a history of injecting drug use were interviewed in depth about their illicit prison drug use, including buprenorphine. Interviews were conducted over 18 months, from August 2006 to January 2008 and were analysed using Framework. The misuse of Subutex by snorting emerged as a significant theme. Accounts suggested that the diversion of prison prescribed Subutex was widespread and prisoners used various tactics to obtain the medication. Various complex and interlinked reasons were given to explain why Subutex was snorted in prison. The main motivation for snorting was to experience a prolonged euphoric opiate effect, believed to help to combat the boredom of being in prison. The price of illicit Subutex in prison was linked to its availability, but it was generally cheaper than heroin, thus contributing to its use. Participants’narratives identified the belief that snorting Subutex in prison was not risk free, but risks were lower than continuing to use other drugs, particularly injecting illicit opiates. The implications of prison Subutex misuse for prisoners, prison medical services, commissioners, and prescribing policy and practice are discussed.

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why.

Qualitative interviews were conducted with 30 male drug users on release from prison to explore what happened to their injecting drug use in prison. The research was conducted from a pragmatic harm reduction approach using grounded theory.

Not injecting in prison was identified as a pertinent finding and nine overarching themes accounted for this decline. The themes often overlapped with one another, highlighting how the decision not to inject when last in prison was multi‐factorial. Running throughout the themes were participants' concerns regarding the health and social risks attributed to injecting in prison, alongside an appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users when in prison.

This qualitative research offers an updated perspective on illicit drug injecting in prison in England from the view of drug users since health and prison policy changes in prescribing and practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and recovery from injecting drug use.

As prison drug use continues to be a concern worldwide, harm reduction practices serve as an alternative approach to traditional abstinence-only or punishment-oriented methods to address substance use behind bars. The purpose of this study is to present a summary of research surrounding prison-based harm reduction programs.

This narrative review of the international literature summarizes the harms associated with prison drug use followed by an overview of the literature surrounding three prison-based harm reduction practices: opioid agonist therapy, syringe exchange programs and naloxone distribution.

A collection of international research has found that these three harm reduction programs are safe and feasible to implement in carceral settings. Additionally, these services can effectively reduce some of the harms associated with prison drug use (e.g. risky injection practices, needle sharing, fatal overdoses, etc.). However, these practices are underused in correctional settings in comparison to their use in the community.

Various policy recommendations are made based on the available literature, including addressing ethical concerns surrounding prison populations’ rights to the same standard of health care and services available in the community. By taking a public health approach to prison drug use, harm reduction practices can provide a marginalized, high-risk population of incarcerated individuals with life-saving services rather than punitive, punishment-oriented measures.

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.

Imprisonment is common among drug users. However, historically healthcare for injecting drug users in prison in England and Wales has not been equivalent to that offered in community settings. Fiftyone injecting drug users who had a history of imprisonment were interviewed. Interviews focused on the experiences of drug‐related care and treatment in prison. The interviews were analysed using the Framework method. Accounts of prison drug treatment experiences provided valuable insights into drug treatment in the English prison. The participants’ accounts provided a historical perspective, many of which reflected the different practices of different prisons and prison staff and the changes in policy and practice that have occurred in prison healthcare over recent decades. Positive and negative experiences of healthcare and drug treatment in prison were discussed. Issues that affected levels of drug use inside prisons and their receipt of care, support and treatment in prison included prescribing policies, illicit drug availability and prison staff and doctor attitudes. Whilst negative experiences of prison and drug treatment prevailed, users identified that recent policy and practice changes had positively influenced healthcare provision for drug users in prison, particularly the provision of opiate maintenance therapy. Drug users often saw prison as an opportunity to detoxify and contemplate their drug use. Further work needs to build on the positive experiences identified to ensure that prison drug treatment in England and Wales is consistent, effective and efficient in the future.