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Changing patterns of substance misuse in adult prisons and service responses

Drug misuse is a serious threat to the security of the prison system, the health of individual prisoners and the safety of prisoners and staff. Its effects ripple outwards to harm prisoners’ friends and families and the wider community of which they are a part. An increasing number of reports of the misuse of medication in prison and concerns that traditional supply reduction and treatment strategies were ineffective were the initial driver for this thematic inspection. However, the availability of new psychoactive substances (NPS), particularly synthetic cannabis known as ‘Spice’ or ‘Mamba’, became highly prevalent during the preparation for this report. NPS have created significant additional harm and are now the most serious threat to the safety and security of the prison system that our inspections identify.

This thematic inspection examined the changing extent and patterns of drug misuse in adult prisons and assessed the effectiveness of the response to it. The inspection’s remit did not include tobacco and alcohol use by prisoners, which are important issues in their own right and raise significant operational and policy challenges. Of course, there are wider questions to be asked about the legal status of drugs in the community and the historical inconsistency of legal responses to various harmful substances. This report does not address those issues. There is no prospect of any relaxation of the rules governing the substances that are permitted in prisons and so there is an urgent requirement to address the harm that substance misuse causes in prisons in that realistic context.

The report draws on the evidence of 61 adult prison inspections published between April 2014 and August 2015, the 10,702 survey responses from individual prisoners that were collected as part of those inspections, and detailed field work that was conducted in eight prisons between June and November 2014. We spoke to prisoners, prison staff and managers, drugs and health workers, and other experts. We reviewed a wide range of research undertaken by other bodies. We also considered some earlier inspection findings, where relevant. The inspection was carried out by the inspectorate’s research team and specialist health and drugs inspectors.