Prison population: substance use and wider support needs

Research into the substance use support needs of people in prison. One of four studies on the health needs of Scotland's prison population.


1. The other three studies are: (1) physical and general health, including major clinical and long-term conditions, infectious disease, non-communicable disease, sexual health; (2) mental health; and (3) social care and support needs.

2. The Scottish Parliament - Healthcare in Prisons

3. Drug Deaths Task Force

4. MAT Standards, introduced by the Scottish Government in 2021, are an evidence-based set of standards to enable the consistent delivery of safe, accessible, high-quality drug treatment across Scotland.

5. Self-reporting results in limited findings as, particularly in relation to substance use, it is uncommon for people to be completely honest in their self-disclosures and so results in data consisting of what people are willing to self-disclose.

6. It should be acknowledged here that rehabilitation opportunities do vary across prisons and prisoner categories.

7. National mission - Alcohol and drugs

8. Those individuals who have left a Scottish prison within the preceding 12 months.

9. AUDIT is a ten-question alcohol harm screening tool developed by the World Health Organisation.

10. Abstaining from committing crime following a period or pattern of offending.

11. This is a recognised policy for at least some SPS establishments but we have been unable to confirm if this is consistently available.

12. NHS guidance available at this time indicates that e-cigarettes are less harmful than smoking. Using e-cigarettes to stop smoking - NHS

13. Integration Authorities, Health Boards and Community Justice Partnerships hold statutory responsibilities for the provision of Prison Healthcare and coordination of through care.

14. In 2009, the Scottish Government set out a framework for the delivery of alcohol and drug treatment and recovery services across the country. Key features of the framework included: (1) a dedicated partnership on alcohol and drugs operating in each local authority area, firmly embedded within wider arrangements for community planning, to be called an Alcohol and Drugs Partnership (ADP); (2) an expert local team supporting the operation of every ADP; (3) where a particular Health Board area includes more than one Local Authority area, appropriate co-ordination arrangements at NHS Board area level.

15. Some areas of Scotland have delegated Community Justice responsibilities to their Integration Authority so that the responsibility sits in one place. It only becomes the responsibility of the local ADP if the Integration Authority or Community Justice Partnership clearly passes this responsibility for decision making to the ADP.

16. SHORE Standards

17. Housing First - Homeless Network Scotland: we are all in

18. The research team acknowledge the brevity of this particular section on mental health. This was a deliberate decision, to avoid repetition of messages that are contained in (1) the related Mental Health Needs Assessment, 2022, (2) co-occurring/psychiatric findings presented in further down in Chapters 3; and (3) mental health findings presented in Chapter 4.

19. Research respondents provided consent for these findings to be shared and discussed with the research team at the University of Edinburgh who are conducting the concurrent Mental Health in Scottish Prisons Needs Assessment study.

20. Blotter sheets are made by soaking the (blotting) paper in a solution of a particular substance. This allows the substance to absorb into the blotter paper. The paper can then be divided into squares or strips.

21. For example some reported improvements in breathing issues.

22. Health & Social Care Analysis - Prison to Rehab Pathway

23. At the time of writing, SPS Prison Population data showed that 1,972 people were on remand out of 7,481 individuals in custody.

24. This was for a variety of reasons but first and foremost because there is no obligation on prisons to provide these to remand populations.

25. Commission on Women Offenders

26. Photocopying of mail is becoming more common now following a change in prison rules last year.

27. For example we found that some geographic areas were better suited to house individuals immediately or that if an individual was released to an area where they could physically travel to a pharmacy before the weekend then they didn't experience delays in their prescriptions.

28. The relationship between a prison worker and those who were imprisoned was felt by respondents to be unique, and one which did not lend itself to open and vulnerable communication.

29. Conducted by the University of Edinburgh research team who have completed the Mental Health Needs Assessment study as part of the current and overarching Health Needs Assessment study of Scotland's prison population. Full details of the literature search conducted can be accessed in the Mental Health Needs Assessment report.

30. Number of studies reporting prevalence in a UK general prison population.

31. Framework for Action: Data Standards in Scotland's Public Sector. Report to the Data Standards Team, Scottish Government. Anderson Solutions (Consulting) Ltd. October 2021.

32. See HM Government Information Principles. HM Government. 2011.

33. Who took part in the data collection.

34. ADP Boards bring together local partners including Health Boards, Local Authorities, Police and Third Sector agencies.

35. Scottish Government. 2018. Rights, Respect and Recovery: alcohol and drug treatment strategy.

36. Scottish Government. 2020. Preventing drug-related deaths in Scotland: emergency response strategies - January 2020.

37. Scottish Government. 2018. Alcohol Framework 2018.

38. Scottish Government. 2019. Partnership Delivery Framework to Reduce the Use of and Harm from Alcohol and Drugs.

39. Scotland has 30 ADPs, all of which are based on Local Authority boundaries. There are 32 Local Authorities in Scotland. There are two areas where ADPs have joined across two Local Authority areas, hence why there are 30 ADPs and not 32. The two areas are: Clackmannanshire/Stirling and Mid/East Lothian.

40. To include (but not be limited to): all Scottish Prisons, the National Prison Care Network, all Scottish Health Boards, the Criminal Justice Third Sector Forum (CJVSF), all Integration Authorities, and all ADPs.



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