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Pattern of women's drug use alters in prison



Pattern of women's drug use alters in prison Illegal drug use is reduced when women enter prison and their pattern of misuse changes from street drugs to prescription medicines.

Prior to imprisonment, just over half of the women entered into the study had been using an illicit drug on a daily basis, and 38% were ever injectors. Following entry into custody, 14% of the sample continued to use an illicit drug daily, and 2% of women continued to inject.

This study used participants from 13 women's prisons across England.

All women entering prison on a certain day were enrolled in the study, and only those who presented a security risk or who had significant mental health problems were excluded. Women were interviewed on admission to prison and again one month later.

A total of 505 women were entered into the study. Of 256 still in prison after one month, 220 participated in the follow-up questionnaire. Complete data on drug use before and during imprisonment was available for 217 cases.

In the six months prior to imprisonment, 75% of women entered into the study had used an illicit drug at least once, 35% were using crack daily and 37% were using heroin daily.

Following admission to prison significantly fewer women were using illicit drugs, though 14% reported use of at least one illicit drug daily. Four women had injected following admission to prison. The drugs used most frequently following imprisonment were benzodiazepines and non-heroin opioids including methadone.

Women using drugs were more likely to be white, younger, unemployed, to have left school aged 16 or younger, to drink more than recommended, and to report previous mental health problems.

This study highlights the many challenges facing prison-based primary care services. These include:
* providing adequate drug treatment services which are effective in reducing illicit drug use
* harm reduction initiatives to lower the prevalence of injecting use with its related risks
* policy and practice which minimise the opportunity for prescribed medication to be diverted as a source of illicit drugs
* prevention of post-release opiate overdose death in those who stop using heroin on admission to prison and lose opiate tolerance.

Plugge E, Yudkin P and Douglas N. Changes in women's use of illicit drugs following Imprisonment. Addiction 2009; 104: 215-222


Dr Jez Thompson
GP and Clinical Director NHS Hull Social Inclusion Services

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