What we learned about alcohol and drug treatment in prisons from the 2016-17 statistics

The 2016-17 statistics report for people receiving drug and alcohol treatment in prisons and other secure settings in England shows similar patterns to what we have recently seen in community treatment.

The report is only the second of its kind meaning it’s too early to see trends but we can compare to the previous year. Below is a summary of the main points from this year’s numbers:

Numbers in treatment have fallen

Over 59,000 adults received treatment for drug and alcohol problems within secure settings during 2016-17. Most of these were in prisons (as opposed to other settings like young offender institutions and immigration and removal centres) but this number is around 1,100 less than 2015-16.

Almost two-thirds of the treatment adult prisoners received was psychosocial, the remaining treatment interventions were pharmacological (meaning medicines were prescribed), including 23% for opiate misuse. This counters a commonly held misconception that most prisoners in drug treatment are on methadone. Half of all adults getting treatment were there for problematic opiate use. A further 37% had problems with other non-opiate drugs and for 13%, alcohol was their only problem substance.

The fall in people accessing treatment for alcohol problems is the main reason for why overall numbers in treatment are down. As we only have two years of data for prisons, we’re not yet in a position to say that the fall in alcohol numbers since last year is a trend. But we do know that alcohol treatment numbers have been falling for a few years in the community and we’re now starting some work to understand why this is.

But numbers of people with problematic crack use are on the rise

Despite the overall fall in treatment numbers, the number of adults coming to treatment for crack cocaine, and particularly crack and opiates, has increased substantially since last year. Overall, there were 3,271 more people accessing treatment for crack than in 2015-16, an increase of 17%. Almost two-thirds (63%) of the opiate users also had crack problems, up from just over half (54%) in 2015-16.

These increases reflect what we have seen in community treatment and the increase in the recent crack prevalence estimates. The increase in the number of people using crack cocaine is concerning but it’s encouraging to see services responding well.

There was an increase in people treated for new psychoactive substances

We have seen a small increase (from 6% to 8%) in the number of people reporting problems with new psychoactive substances (NPS). This goes against the trend in community treatment where we have seen substantial decreases.

Given the anecdotal reports of large numbers of prisoners taking NPS, particularly Spice, this is to be expected. What’s important to remember is that this data refers to the people who have come forward for treatment and are receiving help for their problem – there may be many more prisoners using NPS but not looking for any help with their drug use.

There was an increase in deaths, although the numbers are relatively low

In 2016-17, 65 adults died while attending treatment, an increase of 59% from last year. But, this represents only 0.1% of all the adults who get treatment in a secure setting.

What we don’t know is if these deaths are drug-related or not. They are against a backdrop of rising deaths in the prison estate in England and Wales. Ministry of Justice statistics show that there were 344 deaths between April 2016 and March 2017, an increase of 54 (19%) from the previous year.

We do know that over half (58%) of the 65 deaths were among opiate users (38 deaths, up from 22 in the previous year), and almost a third were receiving treatment for non-opiate drugs (20 deaths, up from 8 in 2015-16). Deaths among people in treatment for alcohol use alone fell to 7 from 11 in 2015-16.

 Continuity of treatment between prisons and community can be better

A recent report published by the Ministry of Justice and PHE shows that if people who use crack and other drugs get into treatment, their offending reduces.

So when prisoners who are getting treatment are released, it’s very important that their treatment continues properly in the community. However, this report shows that there is still poor pick-up of released prisoners who need further treatment – only 30% remain in treatment, which is the same as last year. This is despite continuity of treatment in the community being included as part of the public health outcomes framework (PHOF) and an indicator in the government’s updated drug strategy.

As we’ve seen increases in crack use and the probable links to offending, this remains a concern, particularly as nearly half of the people leaving prison treatment were discharged to continue their treatment in the community.

from Public health matters http://ift.tt/2DS7EW7