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Duke K, Gleeson H, MacGregor S, Thom B. The risk matrix: Drug-related deaths in prisons in England and Wales, 2015-2020. JOURNAL OF COMMUNITY PSYCHOLOGY 2023. [PMID: 36601729 DOI: 10.1002/jcop.22989] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/16/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
This article explores the factors contributing to drug-related deaths in English and Welsh prisons between 2015 and 2020. Based on content analysis of all Prison and Probation Ombudsman 'other non-natural' fatal incident investigation reports, descriptive statistics were generated. Qualitative analysis explored the circumstances surrounding deaths and key risk factors. Most deaths were of men, whose mean age was 39 years. Drug toxicity was the main factor in causing death, exacerbated by underlying physical health conditions and risk-taking behaviours. A variety of substances were involved. New psychoactive substances became more important over time. A high proportion had recorded histories of substance use and mental illness. During this period, the prison system was under considerable stress creating dangerous environments for drug-related harm. This study highlights the process of complex interaction between substances used, individual characteristics, situational features and the wider environment in explaining drug-related deaths in prisons. Implications for policy and practice are discussed.
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Affiliation(s)
- Karen Duke
- Drug and Alcohol Research Centre, Middlesex University, London, UK
| | - Helen Gleeson
- Drug and Alcohol Research Centre, Middlesex University, London, UK
| | - Susanne MacGregor
- Drug and Alcohol Research Centre, Middlesex University, London, UK
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Betsy Thom
- Drug and Alcohol Research Centre, Middlesex University, London, UK
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Mongiatti M, Bayle P, Lagarrigue A, Fabre D, Telmon N, Lapeyre-Mestre M, Jouanjus E. The cardiovascular health of prisoners who use cannabis: An exploratory study among hospitalised prisoners. Therapie 2020; 75:579-589. [PMID: 32718583 DOI: 10.1016/j.therap.2020.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/09/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE It is essential that health professionals who practice medicine in prison rely on accurate knowledge about their patients to provide them with adapted care. The use of cannabis can influence the health status of prisoners, but data are lacking regarding the potentially related adverse health consequences. The objective of this descriptive study was to describe the cardiovascular outcomes related to cannabis use in prisoners from several detention centres hospitalised in a French hospital. METHODS In France, prisoners who require a longer than 48-hour hospitalisation are admitted in specific secured polyvalent units called inter-regional secured hospital units (ISHU). Hospitalisations in the ISHU of Toulouse University Hospital between 2012 and 2016 for cardiovascular disorders potentially related to the use of cannabis were extracted from the French hospital database and analysed using a previously validated methodology. Included patients were those hospitalised for an inaugural cardiovascular event or deterioration of a preexisting cardiovascular illness who declared having used cannabis while imprisoned. RESULTS Overall, 31 cardiovascular outcomes were identified in cannabis-using hospitalised prisoners among 411 hospitalisations for cardiovascular disorders (all men, mean age 43±SD years old). All used cannabis (daily: 56%) and tobacco (more than 15 PY: 83.3%), 5 used cocaine, and none used alcohol. The most frequent were coronaropathy (n=13), followed by obliterating arteriopathy of the lower limb (OALL, n=7), arrhythmic cardiomyopathy (n=4), venous thrombosis (n=3), infectious cardiopathy (n=2), and ischemic stroke (n=2). CONCLUSION This description of serious cardiovascular outcomes in prisoners who use cannabis provides insights into the clinical features possibly observed in this vulnerable population The findings indicate that 7.5% of hospitalizations of prisoners for cardiovascular disorders are potentially linked to cannabis used in prison.
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Affiliation(s)
- Marion Mongiatti
- Forensic medicine and medicine in prison environment department, inter-regional secured hospital unit, Toulouse Rangueil university hospital, 31059 Toulouse, France
| | - Paule Bayle
- Forensic medicine and medicine in prison environment department, inter-regional secured hospital unit, Toulouse Rangueil university hospital, 31059 Toulouse, France
| | - Aude Lagarrigue
- Forensic medicine and medicine in prison environment department, inter-regional secured hospital unit, Toulouse Rangueil university hospital, 31059 Toulouse, France
| | - Dider Fabre
- Department of medical information, Toulouse university hospital, Hôtel-Dieu Saint-Jacques, 31059 Toulouse, France
| | - Norbert Telmon
- Forensic medicine and medicine in prison environment department, inter-regional secured hospital unit, Toulouse Rangueil university hospital, 31059 Toulouse, France; AMIS (molecular anthropology and synthesis imagery) laboratory, CNRS 5588, university of Toulouse, 31059 Toulouse, France
| | - Maryse Lapeyre-Mestre
- Pharmacoepidemiology research team, INSERM 1027, university of Toulouse, 31000 Toulouse, France; Addictovigilance center, department of medical and clinical pharmacology, Toulouse university hospital, 31000 Toulouse, France
| | - Emilie Jouanjus
- Pharmacoepidemiology research team, INSERM 1027, university of Toulouse, 31000 Toulouse, France; Addictovigilance center, department of medical and clinical pharmacology, Toulouse university hospital, 31000 Toulouse, France.
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Hemming L, Bhatti P, Shaw J, Haddock G, Pratt D. Words Don't Come Easy: How Male Prisoners' Difficulties Identifying and Discussing Feelings Relate to Suicide and Violence. Front Psychiatry 2020; 11:581390. [PMID: 33362602 PMCID: PMC7758448 DOI: 10.3389/fpsyt.2020.581390] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/11/2020] [Indexed: 11/16/2022] Open
Abstract
Suicide and violence are prevalent within male prisons in the UK. It has been suggested that alexithymia may be associated with both suicide and violence. Alexithymia can be defined as an inability to identify or discuss emotions. The present study aimed to qualitatively explore male prisoners' experiences of alexithymia and how these experiences may relate to suicide and violence. Fifteen male prisoners were recruited from two prisons in the North West of England. All participants had experienced suicidal and/or violent thoughts and/or behaviors in the past 3 months, and all screened positive on an established measure of alexithymia. Participants took part in a qualitative interview during which they were also given the opportunity to provide drawings of their emotions. Data were transcribed and analyzed using thematic analysis, with a collaborative approach taken between researchers and an individual with lived experience of residing in prison. The results indicated that male prisoners tended not to talk about their emotions with others, due to external pressures of residing in prison in addition to internal difficulties with recognizing and articulating emotions. Not discussing emotions with others was associated with a build-up of emotions which could result in either an emotional overload or an absence of emotions. Both experiences were perceived to be associated with hurting self or others, however, participants also identified a "safety valve" where it was acknowledged that using more adaptive approaches to releasing emotions could prevent harm to self and others. These findings suggest three main clinical implications; (1) a cultural shift in male prisons is needed which encourages open communication of emotions (2) individualized support is needed for those identified as experiencing a difficulty in recognizing and articulating emotions and (3) prison staff should encourage alternative ways of releasing emotions such as by using harm minimization or distraction techniques.
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Affiliation(s)
- Laura Hemming
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Peer Bhatti
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Jennifer Shaw
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Sciences Centre, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Sánchez FC, Fearn N, Vaughn MG. Prevalence and correlates of in-prison substance use among incarcerated women in Spain. J Ethn Subst Abuse 2017; 17:356-374. [DOI: 10.1080/15332640.2016.1255579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Sánchez FC, Wolff N. The association between substance use and physical victimization among incarcerated men in Spanish prisons. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 50:9-16. [PMID: 27816218 DOI: 10.1016/j.ijlp.2016.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 09/13/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
Physical victimization and substance use are common behaviors inside prisons. Yet little is known about whether there is an association between substance use and physical victimization among male inmates. We examined the absolute and relative association between substance use (prior to, during, and both prior to and during incarceration) and physical victimization while incarcerated. For this study, 2484 men (mean age of 36.3years; SD=11.1) were sampled from eight prisons located in Spain. Information was collected using self-report questionnaires probing experiences of physical victimization while incarcerated and substance use prior to prison and during the past six months in prison. We found that the rates and likelihood of physical victimization were greater for male inmates who used substances at any time, compared to non-consumers of substances but were highest for male inmates who used exclusively in prison or both prior to and in prison. These findings suggest the need for immediate prevention steps including comprehensive screening and segregation practices; better drug interdiction practices; and more evidence-based substance abuse treatment with and without integrated trauma treatment to ensure public health and safety.
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Affiliation(s)
- Francisco Caravaca Sánchez
- Department of Criminology, Universidad Católica San Antonio de Murcia, Avenue of Jerónimos, Guadalupe, 30107 Murcia, Spain.
| | - Nancy Wolff
- Bloustein Center for Survey Research, Rutgers, The State University of New Jersey, 33 Livingston Avenue, Office 273, United States
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Kolind T, Duke K. Drugs in prisons: Exploring use, control, treatment and policy. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.3109/09687637.2016.1153604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Torsten Kolind
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, Bygn 1322, Aarhus C 8000, Denmark,
| | - Karen Duke
- Drug and Alcohol Research Centre, Middlesex University, The Burroughs, Hendon, London NW4, UK
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Mjåland K. Exploring prison drug use in the context of prison-based drug rehabilitation. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.3109/09687637.2015.1136265] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
BACKGROUND Although there is a need for well-designed evaluations, international evidence shows that drugs frequently enter prisons and enforcement efforts are said to be linked to adverse events. OBJECTIVES This study sought to examine drug enforcement within a federal prison system, overseen by the Correctional Service of Canada (CSC), and to detail competing perspectives. METHODS Three main sources of data were used in this qualitative study: 16 interviews conducted between 2010 and 2012 with former CSC senior officials, former frontline staff, and external stakeholders; CSC research publications and other documents; and transcripts from a relevant House of Commons Standing Committee public study. All texts were coded and compared to examine emergent themes of interest. RESULTS Six key themes are described as contested effects of enhanced in-prison drug enforcement: (1) continued and creative efforts to bring in drugs; (2) climate of tensions and violence; (3) prisoners switching their drug use; (4) health-related harms; (5) deterrence of visitors; and (6) staff involvement in the in-prison drug trade. CONCLUSIONS/IMPORTANCE Urgently needed are rigorous evaluations of in-prison drug enforcement, along with closer scrutiny of policy recommendations that uphold the goal of drug-free prisons. Studying similar prison systems as complex risk-managing organizations may offer new information about drug enforcement policy and practice resistance despite detrimental effects.
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Affiliation(s)
- Tara Marie Watson
- a Centre for Addiction and Mental Health, Social and Epidemiological Research , Toronto , Ontario , Canada
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Kolind T, Holm K, Duff C, Frank VA. Three enactments of drugs in Danish prison drug treatment: Illegal drugs, medicine and constrainers. DRUGS-EDUCATION PREVENTION AND POLICY 2015. [DOI: 10.3109/09687637.2015.1109608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Torsten Kolind
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark and
| | - Karina Holm
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark and
| | - Cameron Duff
- School of Management, RMIT University, Melbourne, VIC, Australia
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Kolind T. Drugs and discretionary power in prisons: The officer's perspective. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:799-807. [DOI: 10.1016/j.drugpo.2015.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/25/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
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Bartlett A, Dholakia N, England R, Hales H, van Horn E, McGeorge T, Moss B, Ovaisi S, Tukmachi E, Patel S. Prison prescribing practice: practitioners' perspectives on why prison is different. Int J Clin Pract 2014; 68:413-7. [PMID: 24674704 DOI: 10.1111/ijcp.12362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The current prison population in England and Wales has multiple, complex healthcare needs, presenting unique challenges to those caring for prisoners. Prison numbers have increased dramatically in the last 10 years. There are now approximately 84,000 prisoners in England and Wales and 120,000 new episodes of imprisonment each year . The authors all contribute to prison healthcare. Below, we discuss a key issue arising from first-hand experience of prisoners' health and social care needs, the prescription of psycho-active drugs by primary and secondary care practitioners. This is a core medical task, but beset with difficulties. These difficulties are not necessarily encountered in other areas of prison healthcare. However, they do illustrate how providing healthcare to prisoners is complex, often lacking a research base and can have pitfalls that are not obvious to the outsider.
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