Substance Abuse in Prison - Research Paper Example

Substance Abuse in prison Introduction Prisons are collections which hold diverse drug offenders and issue punishment to those who are caught experiencing drug use or transition. Prisons play an essential role in drug policy as they endeavor to minimize the harms caused by drugs in the society. It is debatable whether imprisonment solves the drug menace in the society as many argue that it increases the taxpayer’s burden. Also large scale incarceration of youth associated with drug use may not be a solution and the desired outcomes might not be achieved at the long run since the many they are, the more the potential of continuing with substance abuse while still in prison (Bewley-Taylor, Trace, & Stevens, 2005). This paper will evaluate the prevalence of substance abuse in prisons and also their health implications to the users. Adequate literature will also be reviewed to identify the effective responses which have been formulated to deal with the problems of substance abuse in prison as well as the evidence of harm reduction strategies. This paper hopes to give insights and motivation for those countries going through the same menace to consider implementing such responses to curb the drug use in their prisons. Drug users and drug use in prisons The prison population is composed of a large percentage of drug users particularly in the developed countries. According to Zurhold, Stöver, & Haasen, (2004), there is an estimated fifty percent of prisoners who have been involved with substance abuse a time in their history in the European Union and an estimated 80% of prisoners in the USA. Injecting drug users are more than 50% of the entire population of the drug users in prison (Dolan et al., 2007), while in the contemporary community, they account for barely 1-3% which shows that drug use in prison is more dangerous than in the broader community (Aceijas et al., 2004). Many users of drugs in prisons are highly dependent on the drugs as more than 80% of prisoners in developed countries have been reported to have been under the influence of illicit substances while they were in prison. The situation is mostly prevalent because most of the notorious drug users have been in prison at a point in time. The collection of many large scale substance abusers at the same time and at the same place enhances exchange of ideas and practices such that the result of it is a population of heavy abusers of drugs and other illicit substances. Many prisons have put very strict measures to inhibit the entry of drugs in the prisons but in most countries, this has been very unsuccessful. Despite those measures, prisoners continue to have access to the drugs from outside the prison through devious ways. Most of the illicit substances used in prison are cannabis and heroin. Reviews of European studies by Stöver et al (2001) reveals that the use of cannabis in prison has decreased significantly especially in developed countries while heroin has become the most commonly used illicit substance used in prisons. Heroin is mostly injected serially by prisoners with their prevalence ranging from 16% and 60%. Substance abuse in prison is influenced by the strictness of prison conditions. When prison authorities impose strict limits to prevent entry of drugs into prison, usage of drugs significantly reduce with some users reducing their consumption while others stop using them for such a period of time as it is strictly prohibited. The prison environment is also not a conducive environment for prisoners who have no history of drug use as they have been reported to start using drugs in prison while petty drug offenders increase their use. When prisoners come together, they switch drugs (Small et al. 2005). When prisoners spend long lengths of their lives in prison, they change their psychosocial characteristics and so many of them tend to switch drugs. Many prisons have taken to drug testing to reduce the prevalence of the exercise but the prisoners often switch to substances with shorter detection time such as heroin which disappears shortly from the system such that one is clear before the testing time. This is the reason why there has been a declining rate of cannabis usage and an increase in heroin because cannabis has a very high detection capacity. Prison provides a very ample environment for those people who have never tasted drugs to start experimenting. As they interact and live with experienced drug users, they resort to injection as it is considered to be the most efficient way of administering the drug due to the shortage in prison. According to a survey done in England prisons, the results indicated that those who started using heroin while in prison were estimated to be a quarter of the prisoners using the drugs in prison. Using injections and shared needles in prison is highly associated with ignorance especially in developing countries where such activities are highly dangerous in the spread of HIV and AIDS. This indicates that prisoners do not attract much health care services in prison. Risks resulting from substance abuse in Prison Substance abuse is a crime as it causes destruction to individuals and to the society. There are three types of risks which are represented by use of drugs in prison. There is a risk to the public health where the drug abusers pose a danger to the public as engage in dangerous activities which impact on the overall society. The next risks are the risk of reoffending which results from those drug users who have rehabilitated and would go back to using the drugs again. Lastly, there is the risk to the prison’s security. Current prison systems especially those in the developing world are faced with major health problems related to the misuse of drugs in prison with the issue of spreading HIV/AIDS in prisons taking core positions in health concerns. The prevalence of HIV/AIDS in prison is ranked in the top four communities to be highly infected as compared to the broader population Hellard & Aitken, (2004). Imprisonment is the leading transmission avenue for HIV which increases health risks. The use of drugs and inappropriate sexual encounters with prisoners who have short incarceration period results in transmission of the menace and the HIV/AIDS from the prison to the broader society when the prisoners get out of prison and spread the disease. This however does not compare to the high rates of drugs use in the prisons because in the outside world, drug users are more cautious and there are no high rates of using injections like in prison. Prisoners more aggravate their risks by sharing injection equipment and engaging in unprotected sex with their fellows while in prison and also when they get out of prison. This is because the use of drugs impairs one’s judgment and such people tend to be carefree about such health risks and spreading of diseases. Drug addition, sharing of injective instruments, unprotected sexual behaviors, body piercing, assault and body tattooing are major enhancers of spreading HIV in prison. According to Dolan et al, (2004), there has been evidence of dependent drug users spreading HIV as there has been a very strong connection between offending and addicted substance users. When addicted prisoners are released out of prisoner, there are very high chances that they will be back in prison for offences of reoffending. Imprisonment can be utilized by prison managements to address the prisoner’s addiction to the drugs which can lead to improved reduction of reoffending and the sidelining of discharged prisoners most of who reoffend because of victimization is different areas of the society such as employment and providence of social services. The most relentless reason for the high quest of dealing with issues related to drug use in prison is to prevent the instantaneous danger posed to the prison’s security and that of the prisoners. Drug users tend to lose their control and take no responsibility for their actions. Their carelessness results into physical assaults to their fellow prisoners and prison staff like bullying, attacks and corruption. The smuggling of phones into the prison is the largest facilitator of drug dealing and drug facilitators. Phones are also used by prisoners to plan attacks, robberies, planning escape tactics and criminal activities. The reason most countries especially the developing ones have devastating effects of drug abuse in prison is because their preventive measures are very inadequate and the treatment of AIDS in prison has not been given much attention. Thus, prisoners are placed at high risk of HIV infection. The unreliable doses of drugs prisoners get and the shortage of the drugs mostly affect the body’s mechanisms of dealing with common body mechanisms. This exposes the prisoners to wavering high and low dosage of drugs. When prisoners lack the drugs and then get high doses after some time, they suffer the risk of overdose and even death. Other health risks associated with wavering dosage are contaminated drugs, suicide and loss of tolerance. Drug treatment and services in prisons Offering services related to the treatment of drug abuse in prison poses a lot challenges especially due to the lack of information, drug switching and ignorance of the authorities that re supposed to handle such treatment. Even the authorities that are interested in solving this problem face difficulties in establishing the relevant information to help them establish a good basis for their analysis. Many prisons globally are in deplorable state more so in third world countries and the governments do not prioritize the need for resources to be employed in the prisons while there are other demanding sectors of the economy. This results in prisons having very limited resources such that apart from ensuring the security of prisoners and preventing their escape, very little is left for ensuring healthcare services and treatment of drug-related illnesses and HIV which makes the compromise and the balancing of healthcare and security very challenging for the prison management. If prisoners are provided with adequate healthcare and treatment through the provision health care services which are adequately equipped, a large percentage of them will have reduced impacts and the criminal tendencies of such prisoners will decline too. This will follow a series of other benefits such as reduced cases of corruption, assaults, bullying, inappropriate sexual behaviors, improved management of the prisons, decline in criminal activities, robberies, crimes committed inside prison by phones to raise money for drugs and a wide range of other benefits related to health of the prisoner specifically and the community at large. Prison authorities hinder the reduction of the harm resulting from drug use which is often blamed on the outside community for providing drugs to the prisoners. The prison management feels that they have done a lot in ensuring drugs do not get in the prisons but their efforts are curbed by people who secretively smuggle drugs into the prison. This view is very debatable considering that some police and prison wardens are held accomplices for helping prisoners gain access to the drugs in exchange for a fee. The prison authority is also in high levels of denial as to the high rates of drugs and substance abuse in the prisons. This presents the lack of responsibilities and accountability by the authorities who are mandated to handle such problems. With the character of ignorance and carefree, the problems continue to persist. Harm reduction strategies Harm reduction strategies have been noted to work on the prisons in which they have been implemented. This can be analyzed by evaluation of detoxification, needle exchanges, maintenance prescribing, therapeutic communities and drug-free units in prisons. Treatment and health services should be provided systematically to prevent disconnect in the behavior of the prisoner. Harm reduction strategies hold that the needs of the prisoners should be individualized such that efforts made to remedy a prisoner are matched towards their respective rehabilitation mechanisms (Friedmann, Taxman, & Henderson, 2007). Some evidence that harm reduction strategies are effective in reducing drug use in the prisons can be seen from the following: Detoxification This is the management of symptoms which results from withdrawal of drug addicts from their drug bondage after they cease to use the drugs. In prison, prisoners are helped to undergo detoxification which enables them to reduce the amount of drugs in the blood. Medical detoxification is mostly used to manage high levels of addiction. Other ways to manage addiction of drugs which is not very serious can be managed by nonmedical detoxification which entails providence of care and psychological support to the addict (Department of Health et al., 2006). The already detoxified prisoners risk to suffer an overdose or even death if they go back to abusing drugs again, therefore, this method should be followed by other support systems which help the prisoner avoid lapsing. Drug-free wings They are rehabilitative treatment measures that are primarily targeted towards rehabilitation of prisoners who have had a long history of drug abuse. The population of prisoners in this category is isolated from the rest of the population who vow to never abuse drugs and other illicit substances again. Regular testing is performed on the inmates in this program to check their progress and prevent them from using the drugs without anyone’s knowledge. Those that test positive for substance abuse are punished while those who test negative are rewarded by increased privileges such as good food, improved accommodation and access to recreational facilities. Available evidence from a systematic review of prisons in USA holds that there was improved reduction of re-imprisonment and reoffending as a result of providing health care to the addiction than when imprisonment had no treatment (Smith, Gates, & Foxcroft, 2006). Needle exchange in prison Although the evidence of needle exchange is not very much, this evaluation is very essential in our analysis as it provides us with a direct comparison of the effects of the treatment programs on the use of drugs by injection. According to the evaluations done by Stöver & Nelles, (2003), the findings indicated that there were no increasing trends in the usage of needles to inject drugs, increase in substance abuse was not indicated, there were no reported cases of threats and assaults by drugged prisoners, and the sharing of equipment used for injecting like needles and drugs were fast declining. Conclusion This paper has demonstrated that there is a very high prevalent of drugs and substance abuse in prisons all over the world. High prevalent rates of substance abusers are in prison where non-abusers are introduced into habit while the others get exposed to more dangerous habits like switching, injecting of drugs and unprotected sex. This has made prisons the leading centres for HIV virus as prisoners who act under the influence of drugs do not have the luxury of caution or concern. Prisoners with short incarceration terms spared the disease when they get out of prison. Although most prisons do not implement health care facilities for prisoners suffering from HIV and other drugs-associated ailments, treatment has proved to the solution to most problems facing the prisons today such as corruption, assaults, bullying, inappropriate sexual behaviors, criminal activities and robberies. Work cited Aceijas, C., Stimson, G.V., Hickman, M., Rhodes, T., and United Nations Reference Group on HIV/AIDS Prevention and Care among IDU in Developing and Transitional Countries. Global overview of injecting drug use and HIV infection among injecting drug users, AIDS 18(17), 2295-2303, 2004 Bewley-Taylor, D., Trace, M., and Stevens, A. Incarceration of drug offenders: Costs and impacts. Briefi ng paper 7. Oxford: Beckley Foundation, 2005. Department of Health, National Treatment Agency for Substance Misuse, Royal College of General Practitioners, Royal College of Psychiatrists, Royal Pharmaceutical Society of Great Britain. 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Stöver, H., and Nelles, J. Ten years of experience with needle and syringe exchange programmes in European prisons. International Journal of Drug Policy, 14(5-6), 437-444, 2003. Stöver, H., Hennebel, L.C., and Casselman, J. Substitution Treatment in European Prisons London: Cranstoun Drug Services Publishing, 2004. Stöver, H., and Nelles, J. Ten years of experience with needle and syringe exchange programmes in European prisons. International Journal of Drug Policy, 14(5-6), 437-444, 2003. Small, W., Kain, S., Laliberte, N., Schechter, M.T., O’Shaughnessy, M.V., and Spittal, P.M. Incarceration, addiction and harm reduction: inmates experience injecting drugs in prison. Substance Use & Misuse, 40(6), 831-843, 2005. Smith, L.A., Gates, S., and Foxcroft, D. Therapeutic communities for substance related disorders. The Cochrane Database of Systematic Reviews, 2006. Zurhold, H., Stöver, H., and Haasen, C. 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