Prison-based psychosocial and health interventions

In prisons, services targeting drug-using inmates are expanding. Most of the countries where addiction treatment is generally available in prisons also provide harm-reduction measures (Table 4). However, an analysis of prison-based programmes contained in EDDRA (Exchange on European Drug Demand Reduction Action) found that the dominating objective of the interventions is not health related but the reduction of drug-related crime (79).

Generally, in any particular country, specific services exist either in almost all prisons or in almost none. This is especially true for harm-reduction measures, as shown in Table 4. Blood screening and vaccination programmes are available and disinfectants and condoms provided in almost all prison establishments inapproximately two-thirds of the countries, but are completely lacking in approximately one-third of Member States. This reflects the crucial role of national policies in determining the availability of prison services. However, pilot projects at the level of individual prisons are usually tried before any policy is rolled out nationwide.

Detoxification is the measure most universally provided. It is available in almost all prisons in nine countries and less widely in only three countries, Greece (2001 data), Italy and Norway. Needle exchange is the most uncommon of the investigated interventions: needle-exchange programmes are available only in Spain (11 of 68 prisons) and in Germany (four of 222 prisons). The accessibility of substitution treatment follows the pattern of availability in community settings (except in the Netherlands) and is available in almost all prisons in six Member States. Other countries offer it in very few of their prison establishments or not at all (Table 13 OL).

(79)  EMCDDA criminal justice based drug demand and harm-reduction interventions in the EU – an analysis of police station, court and prison-based programmes.