Briefing Paper: Drug Use in Prisons in England and Wales

By Amy Pryce

Year 3

Criminology and Sociology Undergraduate Student

Introduction

This briefing paper will discuss drug use in prisons in England and Wales. The prevalence of drug use in prisons varies across different regions and institutions but is a pervasive issue globally (Carpentier et al., 2018). Compared to the general population, prisoners are more likely to have used drugs, use drugs regularly and to experience drug-related issues, including health implications (Kolind & Duke, 2016). Globally it is estimated that 30% of men and 51% of women in prison have a drug use disorder (CoSJ, 2015). However, reliable data may be limited due to underreporting and variations in reporting methods, due to the sensitive nature of the topic (Kolind & Duke, 2016).

This briefing paper will cover the prevalence of drugs in prisons, including illegal, prescription and New Psychoactive Substances (NPS) It will use the importation, deprivation, and mixed model to analyse reasons for drug use. The paper will also examine methods and implications of drug smuggling into prisons and discuss the impacts of drug use. Further, it will analyse current efforts to reduce drug use in prisons, focusing on UK frameworks and strategies. Finally, recommendations will be provided to address the underlying causes and aiming for a reduction in drug use in prisons.

Types of drugs in prison

Various types of drugs circulate within prisons, they are often similar to those in the broader society, however, they may vary depending on availability and which drugs can easily be smuggled into prisons (Donal et al., 2007). This causes offenders to use an alternative drug or route. There are three main types of drugs in United Kingdom (UK) prisons including illegal, prescription and New Psychoactive Substances (NPS) (Watson, 2016).

The first group of drugs are illegal substances sometimes known as ‘traditional drugs’, including cannabis, heroin, and cocaine (Farrell et al., 2002). England and Wales have struggled with illegal drug use in prisons for decades. It is estimated that 75% of prisoners have taken illegal drugs whilst in prison in England and Wales, 30% of prisoners had used cannabis, over 20% of prisoners had used heroin and 10% of prisoners had used cocaine (CoSJ, 2015). However, these statistics are the results of a survey carried out in 2010, which means the information may be outdated and inaccurate (CoSJ, 2015). Additionally, some prisoners who took part in the survey may not have admitted to drug use in prison as it is an illegal and stigmatised activity (Bullock, 2003). Therefore, there may be a fear of further surveillance, sanctions, and punishment if prisoners self-report such activities for data collection (Dillon, 2001).

Secondly, prescription drugs are vital for treating illnesses in prison; however, they are being misused by prisoners in English and Welsh prisons (Fazel et al., 2011). The misuse of prescription medication like antidepressants, tranquillisers, antipsychotics and even paracetamol is a growing concern in many prisons, especially among women (Bi-Mohammed et al., 2017). Some prisoner’s fake illness to obtain prescription drugs, which are then abused or sold to others for misuse (Bi-Mohammed et al., 2017). Additionally, certain inmates may stop injecting drugs due to security measures upon entering prison, leading them to seek prescribed opiates, including methadone and buprenorphine (McDonough, 2019).

Lastly, NPS pose a significant challenge in prisons as they resemble ‘traditional’ drugs but with altered chemical structures to evade current drug laws (Shafi et al., 2020). Their heightened potency increases the risk of overdose (Ford & Berg, 2018). Between June 2013-2016, over 79 prisoner deaths were linked to NPS use, leading to the criminalisation of their sale and supply in the UK (Deuchar & Densely, 2023). Despite this, NPS use in UK prisons remains high, with seizures increasing from 4560 in 2017 to 9114 in 2021, possibly due to their availability and undetectability (Vaccaro et al., 2022).

Reasons for drug use

The deprivation model suggests that drug use in prison is a response to the harsh conditions and deprivations of freedom within the prison environment (Shammas, 2017). According to this model, individuals may abuse substances like cannabis to alleviate the emotional and psychological toll (also known as the ‘pains’) of imprisonment (Sykes, 1958; Mjaland, 2016). Sykes (1958) ‘pains of imprisonment’ refers to a concept of five primary pains experienced by prisoners: deprivation of liberty, deprivation of goods and services, deprivation of heterosexual relationships, deprivation of autonomy and deprivation of security. This sheds light on how the harsh conditions and restrictions within prison environments can exacerbate vulnerabilities to drug use among prisoners (Haggerty, 2020).

The pains of imprisonment may lead some prisoners turning to drugs as a coping mechanism to alleviate boredom, stress or emotional distress (Shammas, 2017). Additionally, the absence of adequate support systems can further drive prisoners towards substance abuse as a means of seeking solace or numbing the psychological toll of imprisonment (Haggerty, 2020). Prisoners may use drugs to escape, wanting to numb themselves from the pains of imprisonment and may find the experiences induced by drugs such as cannabis mimic or parallel the hardships, struggles and psychological experiences associated with imprisonment (Ford & Berg, 2011). The deprivation model also suggests limited autonomy, lack of meaningful activities, and separation from family can create a sense of hopelessness and frustration, prompting inmates to seek solace in drugs, particularly heroin, as a form of escape (Bullock, 2003).

However, the importation model suggests that the reasons for drug use in prisons are not solely a result of the prison environment itself but are also influenced by the social and cultural backgrounds of the individuals entering the prison (Irwin and Cressey, 1962). According to this model, prisoners bring certain values, behaviours and coping mechanisms from their pre-incarceration lives into prison with them and that these factors continue to shape their behaviour in prison (Jacobs, 1997).

The importation model implies that prisoners may already have a history of substance abuse before entering prison (Mjaland, 2016). Evidence supports this by showing that 70% of prisoners report drug misuse before prison (Parliament, 2012). Factors such as pre-existing addictions, personal attitudes towards drug use and involvement in drug-related subcultures can contribute to an individual’s likelihood of using drugs whilst imprisoned (Mjaland, 2016). Consequently, the importation model suggests that the prison environment merely amplifies or provides a new context for existing patterns of behaviour (Jacobs, 1997).

However, most drug use in prison is best explained by the mixed model. The mixed model allows for the coexistence of both the importation model and the deprivation model and combines them together to provide a more holistic approach to understanding drug use in prison (Gillespie, 2005). There is significant evidence to support the mixed model, with the mixed model explaining drug use in prison as occurring due to a combination of the social and cultural backgrounds that people import into prison with them and how these interact with the ‘pains of imprisonment’ (Mjaland, 2016). The mixed model suggests that individuals may carry drug-using behaviours into prison from their pre-incarceration experiences, while also recognising that the unique stressors and challenges of prison life can exacerbate prisoners’ desire to use drugs (Dye, 2010).

For example, individuals’ resort to drug use as coping or escape mechanisms to manage trauma, mental health issues or distressing events in their lives may continue to rely on these strategies upon entering prison. However, the prison environment, characterised by factors such as confinement, limited contact with loved ones, and a pervasive sense of fear can intensify prisoners’ feelings of distress (Mjaland, 2016). This heightened distress can exacerbate their inclination to use drugs as a means of coping (Mjaland, 2016).

Similarly, individuals who usually use drugs to alleviate boredom may find themselves at increased risk of drug use in prison due to the heightened sense of monotony and restricted activities available in the prison setting (Woodall, 2012).

Additionally, individuals who struggle with mental health issues may feel more isolated in the prison environment, which can increase their risk of turning to drugs as a form of self-medication to alleviate their symptoms of anxiety, depression, or PTSD (Fazel et al., 2006; WHO, 2014). The mixed model acknowledges the interplay between pre-existing individual characteristics and environmental factors in shaping drug use behaviours in prison (Deuchar & Densley, 2023).

Methods of smuggling drugs into prison

There are various methods used to smuggle drugs into prisons, this varies between different jurisdictions and prisons depending on the rules they have in place to reduce drug smuggling (Duke & Trebilcock, 2022).

Firstly, drugs are often smuggled into prisons through mail, concealed under stamps, envelope flaps or sprayed onto letters (Schweitzer et al., 2018). However, this method is limited to small amounts, as bulky drugs such as cannabis cannot be effectively smuggled through postage. NPS are commonly smuggled this way due to their high potency, enabling their use in smaller quantities (Giorgetti et al., 2022). Nonetheless, this method poses a significant risk of overdoses due to the concentration of drugs on the paper (EMCDA, 2022). In response, some UK prisons provide photocopies instead of original letters to mitigate these dangers (Norman, 2022).

External visits provide another avenue for smuggling drugs into prisons, with visitors concealing drugs on them or their belongings (Crewe, 2006). Some visitors hide drugs in body cavities, undergarments or infant nappies to overcome stricter rules (Dillon, 2006). The visitors transfer the drugs to prisoners by mouth-to-mouth kissing or provide items like food and drinks with concealed drugs (Inciardi et al., 1993).

Prison staff are also sometimes involved in drug smuggling, driven by financial motives or coercion (Russo et al., 2019). Exploiting their familiarity with security procedures and infrequent drug testing, prisoners may use staff to transport drugs hidden in personal items (Crewe, 2006). To address this possibility, some prisons introduced preventive measures, including random drug tests and restrictions on personal items for staff (Russo et al., 2019).

Throwovers are another common smuggling method, but its use can depend on the prison design and location, with the result that this method can vary in its use between different prisons (O’Hagan & Hardwick, 2017). People may toss items like tennis balls or deceased animals over prison perimeters to deliver drugs, with the drugs hidden instead these items (Watson, 2016). To tackle throwovers, some UK prisons, including Altcourse, have enhanced perimeter security with CCTV cameras and nets, causing prisoners to turn to new technologies like drones to smuggle in drugs instead (Norman, 2022). Drug packages are being attached to drones which are been flown over prison walls and the contraband is being dropped into the prison yard for prisoners to retrieve (Norman, 2022). The various methods employed by prisoners to successfully smuggle drugs into prison directly contributes to the significant impacts of drug use in prisons, including exacerbated physical and mental health issues, increased violence and an increased risk of reoffending.

Impacts of drug use in prison

The consequences of drug use in prison are multifaceted and pervasive, impacting individuals, overall safety, order and rehabilitative efforts within correctional facilities (Kolind, 2015).

Firstly, drug use in prisons poses significant physical implications for prisoners. Exposure to substances of unknown quality can lead to long-term health problems or overdose (O’Hagan & Hardwick, 2017). The common practice of sharing needles among prisoners further increases the risk of transmission of diseases such as HIV, particularly when access to clean needles and proper medical care for prisoners is limited (Goomany & Dickinson, 2015).

Drug use in prison can also affect prisoners’ mental health, particularly those with a history of drug use who already have multiple mental illnesses (Fazel et al., 2006). The stressful and isolating environment of prison, combined with the psychoactive effects of drug use, can exacerbate conditions such as personality disorder, depression, and schizophrenia (WHO, 2014). The prevalence of mental health issues among drug-using prisoners strains available mental health services and hinders rehabilitative efforts due to limited resources and support systems within prisons (Goomany & Dickinson, 2015). Simultaneously, a lack or inadequacy of these services may lead prisoners to self-medicate with drugs, further exacerbating mental health issues and perpetuating a cycle of substance abuse (Deuschar & Densely, 2023).

There is also a significant increase in violence due to drug use in prison, creating a competitive and aggressive environment due to conflicts over territory, distribution, and debts in the illicit drug trade (Norman, 2022). The psychoactive effects of drugs, such as NPS, can escalate aggression, compromising the safety of both prisoners and staff, creating a potentially dangerous environment (Grace et al., 2019).

Violence associated with the drug trade is a significant problem in English and Welsh prisons (McDonough, 2019). When prisoners become involved in the distribution or supply of illegal substances, they may exert control over fellow inmates, staff members or even their own families (McDonough, 2019). This dominance can manifest in various forms, including intimidation tactics, coercion, and physical violence, as individuals seek to maintain their position of power within the prison hierarchy (O’Hagan and Hardwick, 2017). Furthermore, the lure of profit from drug dealing can lead prisoners to engage in blackmail, leveraging their access to drugs as a means of exerting control over others or coercing them into complicity (O’Hagan and Hardwick, 2017). These dynamics create an environment of fear and instability within prisons (O’Hagan and Hardwick, 2017).

Additionally, drug use in prison significantly heightens the risk of reoffending. Over half of drug-abusing offenders reoffended within a year of release, compared to 27% of all offenders (O’Hagan & Hardwick, 2017). Individuals using drugs are more prone to criminal behaviour to sustain their drug use, with two fifths of prisoners in England and Wales admitting to committing offences to obtain money for drugs (O’Hagan and Hardwick, 2017). As such, drug addiction becomes a barrier to addressing the root causes of criminal behaviour, as prisoners struggle to meaningfully engage in educational or vocational programmes (Ford & Berg, 2011).

Participation in rehabilitative programmes is vital for equipping prisoners with the skills and knowledge required to secure stable employment and contribute positively to their communities upon release (HMPPS, 2023). Limited or no participation denies prisoners’ opportunities for personal development, skill-building, and reintegration preparation, making it more challenging for them to maintain stability post-release (Boateng, 2019). Accordingly, diminished engagement in these activities reduces successful reintegration into society upon release (Russo et al., 2019). Without access to these programmes, prisoners encounter barriers to employment, financial instability, a higher likelihood of recidivism and relapsing upon their release from prison (Berghuis, 2018; Razali et al., 2021). Therefore, reducing prison drug use, addressing substance misuse issues, and enhancing programme access and participation are essential for improving outcomes during reintegrating into society.

What is being done to reduce drug use in prisons?

Methods to reduce drug use in prisons involve a combination of preventive, interventional and rehabilitative measures, and several strategies are being implemented to address this issue (HMPPS, 2021).

Enhanced security measures are aiming to reduce drug use in prisons. By implementing rigorous screening protocols for visitors, staff and incoming mail, prisons aim to intercept and deter the smuggling of illegal drugs (O’Hagan & Hardwick, 2017). The effectiveness of these measures depends on staff training and sufficient resources such as money (UNODC, 2021). In 2019, six million pounds was invested on security measures to prevent drugs entering prisons, including scanners, drug dogs and new mobile prevention technology, essential to ensure a safer environment (HMPPS, 2019). However, even though security often takes priority over treatment and health needs due to limited resources, prisoners keep inventing new ways to smuggle drugs into prisons (Norman, 2022). For this reason, the money may be better spent on rehabilitative programmes.

Random and mandatory drug testing (MDT) in prisons aims to discourage drug use by creating uncertainty about when tests may occur, serving as a deterrent with constant risk and disciplinary consequences (Shewan & Davies, 2013). It also helps identify individuals with substance abuse issues for treatment programmes (Shewan & Davies, 2013).  However, MDT may be unreliable and potentially dangerous as it encourages the use of harder drugs like heroin and NPS, as prisoners are less likely to be detected (O’ Hagan & Hardwick, 2017).

For example, heroin only stays in the body for three days, rather than fourteen days for cannabis and MDT procedures cannot detect NPS (O’ Hagan & Hardwick, 2017; Duke 2020). Additionally, the effectiveness of random testing depends on the frequency of tests, accuracy of detection methods, and the provision of rehabilitative initiatives following a positive result (O’ Hagan & Hardwick, 2017). However, prisoners may contaminate their urine samples and the predictability of testing regimes in prisons provides prisoners with opportunities to evade detection, further compromising the reliability of MDT results (Woodall, 2012). MDT is an expensive method evidence does not conclusively show it is effective in reducing drug use within prisons (Wheatley, 2007).

Another method to reduce drug use in prisons is comprehensive rehabilitation services to reduce the number of prisoners entering prison with drug-related issues and equipping prisoners for successful reintegration into society (HMPPS, 2019; Kolind, 2015). Implementing effective pre-incarceration interventions, such as community-based treatment programmes, diversion programmes and harm reduction initiatives can help individuals address their substance abuse issues before they enter prison (Neale, 2004). By providing support and resources to individuals in the community with a greater range of resources, there is a greater chance of reducing drug-related behaviours and preventing further involvement with the criminal justice system (Neale, 2004).

For prisoners with substance abuse issues, effective programmes in UK prisons often include detoxification, the most common intervention for drug-dependent offenders (Dolan et al., 2007). Detoxification can be managed medically with methadone for opiate withdrawal or non-medically through psychological support and care (Dolan et al., 2007). However, additional substance misuse services are often necessary to address the diverse range of drug dependencies and to provide comprehensive support for prisoners struggling with substance abuse issues (Mitchell, 2022). Detoxification can be accomplished alongside psychological and counselling services such as group support sessions, educational programmes on addiction, relapse prevention strategies and vocational training aimed at promoting rehabilitation and reducing recidivism among drug-dependent offenders (HMPPS, 2019; Mitchell, 2022).

Policy Recommendations

  1. Enhancing substance misuse services and mental health services in prisons

Prisoners are more likely to exhibit higher levels of mental health and substance abuse issues compared to the wider population (Butler et al., 2021). Therefore, a policy recommendation should aim to enhance substance misuse and mental health services within prisons. Current drug treatment programmes have the capacity to treat only 10% of offenders and do not tailor the needs for prisoners with severe disorders (Taxman et al., 2013). Therefore, the expansion of substance misuse services will involve increasing access to effective treatment programmes including, cognitive behavioural therapies, medication-assisted treatment and relapse prevention strategies tailored to individual needs (Taxman et al., 2013).

Additionally, vocational training and education programmes should be incorporated because meaningful work can be a positive alternative to drug use (Skyes, 1958; Mjaland, 2016). It can instill a sense of purpose and hopefulness, that prisoners can use as a coping or escape mechanism (Skyes, 1958; Mjaland, 2016). Incorporating substance abuse counselling and support services into work programmes can address the underlying causes of addiction, working towards rehabilitation (Avieli, 2022). Secondly, strengthening mental health services is essential, this includes providing access to mental health assessments, counselling, therapy and psychiatric services to address co-occurring mental health disorders contributing to substance abuse (Avieli, 2022). Trauma-informed care approaches should be integrated to address underlying psychological issues and reduce reliance on drugs as coping mechanisms (EMCDA, 2022). This policy recommendation aims to foster a supportive and therapeutic environment conducive to rehabilitation and successful reintegration into society, ultimately contributing to a reduction in drug-related harm and recidivism rates within prison.

  • Increase the number of drug-free wings across England and Wales

To mitigate drug use in prisons, a strategic policy recommendation should involve the expansion of drug-free wings in prisons (Nylander, 2021). Currently, 45 prisons in England and Wales have incentivised substance-free living units, motivating addicts to cease illicit drug use and reduce their reliance on synthetic opiates (HMPPS, 2023). Progressing prisoners receive incentives and can transfer to a recovery wing for six months of abstinence-based treatments (Nylander, 2021). These wings should incorporate evidence-based rehabilitation, counselling, and vocational training to address the underlying causes of substance abuse (HMPPS, 2023). This encourages prisoners to take responsibility for their recovery and engage in work, education and treatment (McDonough, 2019). Additionally, strict surveillance and rigorous monitoring should be employed to deter illicit activities (EMCDA, 2022). Collaborations with rehabilitation experts inform the design and implementation of the wings (Nylander, 2021). This policy targets the specific needs of individuals struggling with substance abuse, aiming to create safer, more rehabilitative prison environments across England and Wales, fostering lasting change and reducing reoffending (McDonough, 2019). However, success requires sufficient resources, qualified staff, and post-release care to prevent relapse (Kolind & Duke, 2016).

  •  Provide opportunities to develop meaningful relationships.

To combat drug use in prisons, a critical policy recommendation involves developing meaningful relationships among prisoners (Avieli, 2022). Establishing support networks and encouraging positive social interactions between prisoners and staff can serve as a powerful deterrent to substance abuse (Boateng, 2019). From a deprivation model perspective, implementing group counselling sessions, mentoring programmes and peer support initiatives can create a sense of community and reduce the isolation that often contributes to drug involvement (HMPPS, 2023). Furthermore, facilitating family visits and communication can strengthen inmates’ connections with their support systems outside prison walls, providing additional motivation for rehabilitation (Kenemore, 2020). By prioritising and incentivising positive relationships, this policy seeks to create an environment conducive to personal growth and accountability (Boateng, 2019). Addressing the root causes of drug use through meaningful connections not only promotes rehabilitation but also contributes to a safer and more secure prison environment (HMPPS, 2019).

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