Article

Substance abuse and dependence in prisoners: a systematic review. [Research Support, Non-U.S. Gov't Review]

Department of Psychiatry, University of Oxford, Oxford, England, United Kingdom
Addiction (Impact Factor: 4.6). 03/2006; 101(2):181-91. DOI: 10.1111/j.1360-0443.2006.01316.x
Source: PubMed

ABSTRACT To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody.
A systematic review of studies measuring the prevalence of drug and alcohol abuse and dependence in male and female prisoners on reception into prison was conducted. Only studies using standardized diagnostic criteria were included. Relevant information, such as mean age, gender and type of prisoner, was recorded for eligible studies. The prevalence estimates were compared with those from large cross-sectional studies of prevalence in prison populations.
Thirteen studies with a total of 7563 prisoners met the review criteria. There was substantial heterogeneity among the studies. The estimates of prevalence for alcohol abuse and dependence in male prisoners ranged from 18 to 30% and 10 to 24% in female prisoners. The prevalence estimates of drug abuse and dependence varied from 10 to 48% in male prisoners and 30 to 60% in female prisoners.
The prevalence of substance abuse and dependence, although highly variable, is typically many orders of magnitude higher in prisoners than the general population, particularly for women with drug problems. This highlights the need for screening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow-up on release. Specialist addiction services for prisoners have the potential to make a considerable impact.

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    • "One possible explanation is a version of the healthy worker effect: those who are physically healthy may be more able to commit certain crimes and might therefore be at higher risk of re-incarceration. This effect has previously been proposed as an explanation for lower rates of natural deaths during incarceration (Fazel and Benning 2006). Conversely, a history of STI was associated with a marginal increase in risk of return to custody. "
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