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Factors associated with drug use in prison (n = 1499). Unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) from logistic regression
Source publication
Background:
Remarkably little is known about drug use during imprisonment, including whether it represents a continuation of pre-incarceration drug use, or whether prison is also a setting for drug use initiation. This paper aims to describe drug use among people in prison in Norway and investigate risk factors associated with in-prison drug use....
Contexts in source publication
Context 1
... those who had used drugs during the current imprisonment (n = 351), almost all (96%) also reported using drugs during the 6 months before imprisonment. After adjusting for sociodemographic factors and factors related to mental health and criminal activity, the only factors related to prior drug use were independently associated with in-prison drug use (Table 4): number of drugs used in lifetime (OR = 1.12; 95%CI 1.07-1.17; p < 0.001), daily drug use in the 6 months before imprisonment (OR = 7.12; 95%CI 3.99-12.70; ...Context 2
... those who had used drugs during the current imprisonment (n = 351), almost all (96%) also reported using drugs during the 6 months before imprisonment. After adjusting for sociodemographic factors and factors related to mental health and criminal activity, the only factors related to prior drug use were independently associated with in-prison drug use (Table 4): number of drugs used in lifetime (OR = 1.12; 95%CI 1.07-1.17; p < 0.001), daily drug use in the 6 months before imprisonment (OR = 7.12; 95%CI 3.99-12.70; ...Similar publications
Background:
For novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use. This pilot study was performed to examine the use of tobacco products in three Japanese urban regions.
Methods:
This study was a cross-sectional ep...
Citations
... Stigmatized and excluded from mainstream society, for example, people relapse as a direct consequence of the 'frustration and inability to secure a position in normal community life and establish everyday routines' beyond any physical and psychological barriers to recovery (Buchanan, 2004, p.394). Bukten et al. (2020) draw attention to the relationship between drug use in prison and the emergence of other adverse outcomes during and after imprisonment. Research has shown that prison time is often associated with the initiation of injection drug use (for review, see Boys et al., 2002). ...
... Other research finds low rates of identification and treatment in prisons, with over half of prisoners' mental health needs unmet (Fazel et al., 2016;Tyler et al., 2019). Given the high reported rates of drug misuse among prisoners globally, it is also important to acknowledge the relationship between this and the continuing prevalence of mental ill-health among the incarcerated, and the fact that psychiatric co-morbidity is especially apparent among prisoners who use drugs (Birmingham, 2003;Bukten et al., 2020;Enggist et al., 2014). ...
This article presents insights from small-scale qualitative research exploring the intertwining nature of drug addiction and mental ill-health among men in Scottish prisons. Semi-structured interviews were conducted with 24 men in two Scottish prisons. The men’s narratives suggested that increased tension in prison halls had stimulated a huge surge in the use of New Psychoactive Substances (NPS), in turn increasing and deepening existing mental ill-health and violence. They believed health care in the prisons to be of low quality, and that methadone was prescribed as a mechanism for social control. Implications for future policy, practice and research are outlined.
... There are differences among people in prison according to country of birth: those born in the Nordic countries had more severe substance use in the six months before incarceration and reported more injecting drug use compared to those born in other countries. Inmates of Nordic origin also reported more use of narcotics and medications (not prescribed) during imprisonment (452 ...
This report of a rapid review of inequalities in health and wellbeing in Norway since 2014
was commissioned by the Norwegian Directorate of Health to inform the development
of a National Strategy to Reduce Social Inequalities in Health. It is a joint collaboration
between UCL Institute of Health Equity (IHE) and WellFare: Nordic Research Centre for
Wellbeing and Social Sustainability, Department of Education and Lifelong Learning at
the Norwegian University of Science and Technology (NTNU).
... The current prevalence of SUD, on the other hand, fell to 5.71%, which could be partly explained by the institutional bans and detoxification programs implemented in prison. Indeed, a considerable body of evidence suggests that imprisonment may represent a unique opportunity to identify individuals with a history of substance use and initiate addiction treatments that significantly improve their health (Degenhardt et al., 2014;de Andrade and Kinner, 2016;Mundt et al., 2018;Bukten et al., 2020). However, the majority of interventions fail to produce long-term benefits and most prisoners return to use substances upon release (Puljević et al., 2017). ...
... Moreover, our research showed that having a history of SUD was related to repeat incarceration and increased the risk of being convicted for a violent crime, which is consistent with previous studies (Steadman et al., 1998;Baillargeon et al., 2010;Young et al., 2011;Macciò et al., 2015;White et al., 2016;Nacher et al., 2018). Taken together, the present findings emphasize the need to promote detoxification treatments both in prison and as individuals with SUD transition back to the community in order to facilitate their reintegration and employability (Bukten et al., 2020). Indeed, Bahr et al. (2010) examined the extent to which drug treatment was associated with the reentry of parolees after release and found that those who succeeded were more likely to have taken a substance abuse class while in prison (Bahr et al., 2010). ...
Introduction
This study examined, for the first time, the prevalence of mental disorders and comorbidities among inmates who were about to be released, and their association with criminal history.
Methods
A Spanish sample of 140 prisoners at the end of their sentence was recruited from an occupational program. Psychiatric disorders were determined according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Bivariate analyses followed by multivariate regression models were conducted to identify significant variables for repeat incarceration and violent offending.
Results
The lifetime prevalence of Axis I disorders was 81.4%, with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) being the most common diagnoses (51.4 and 31.4%, respectively). The current prevalence of Axis I disorders was 59.0%, including learning disorders (38.6%), ADHD (16.4%), and SUD (5.71%) among the most frequent syndromes. Thirty-six (26.5%) participants met criteria for a current Axis II disorder, which commonly was an antisocial personality disorder (12.5%). The majority of the sample (60.8%) suffered from two or more comorbid disorders during their lifetime, although the current prevalence fell to 23.3%. Childhood ADHD increased the number of imprisonments, while inmates convicted of a violent crime were more likely to present a learning disorder. Having a lifetime diagnosis of SUD or multiple psychiatric disorders appeared to be associated with both repeat incarceration and violent offending.
Conclusion
Given the high rate of mental disorders still present among subjects completing prison sentences and the challenges they may encounter to benefit from vocational programs, our results suggest that appropriate psychiatric care should be provided during imprisonment and after release to facilitate their community reintegration.
... The misuse of an easily available over the counter drug, considered as essential medicine by WHO, being one of the efficacious, safe, and cost-effective medicines for priority conditions [15], must be carefully considered as a possible health risk, especially for inmates. In this population, the search of psychotropic effects by off-label use of psychotropic medicines, which can be more easily available in jail, may happen [16,17]. ...
Scopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.
... Substance use in the community often continues during incarceration (Albertie et al., 2017; Australian Institute of Health and Welfare, 2019; Bukten et al., 2020;Caravaca Sánchez & Wolff, 2020b; European Monitoring Centre for Drugs and Drug Addiction, 2012;Mjåland, 2016;Rousselet et al., 2019;Rowell et al., 2012;Rowell-Cunsolo et al., 2016). Not surprisingly, substance use prior to incarceration is linked to an increase of substance use during imprisonment (Rousselet et al., 2019;Rowell et al., 2012;Sánchez et al., 2018). ...
Introduction
We know little about the prevalence and patterns of substance use during incarceration, and we know even less about comparative substance use patterns by gender. To address these gaps in the literature, this study used latent class analysis (LCA) to identify substance use subgroups of incarcerated men (n = 1118) and women (n = 207).
Methods
The study drew data from six prisons in Spain. Participants completed a self-administered questionnaire with items probing for types of drugs used in the past three months, depression, anxiety, stress symptoms, aggressiveness, and perceived social support.
Results
Substance use was common among incarcerated men and women, with tobacco, cannabis, and sedatives being most prevalent. LCA revealed different patterns of substance use by gender. Four- and two-class solutions best fitted the data for men and women, respectively. Aggressiveness and depression were associated with high depressant use membership for men. Among women, aggressiveness and anxiety symptoms were positively associated with high polydrug use membership.
Conclusions
The prevalent and patterned use of substances inside Spanish prisons and their association with aggressiveness and depression elevates the risk of harm during incarceration. In the interest of safety and wellness, correctional behavioral health services should include and expand the availability of gender-specific integrated mental health and substance use interventions that address maladaptive behaviors such as aggression.
... Brukere av AAS benytter ofte andre rusmidler i tillegg -en såkalt «polydrug use», (se f.eks. Havnes 2020c, Sagoe et al. 2015, Salinas et al. 2019, og dette er tilfellet også for innsatte i fengsel (Bukten et al. 2020, Havnes et al. 2020a, Klötz et al. 2010. En studie av Gårevik og Rane (2009) av arrestanter i Stockholm viste at foruten omfattende «polydrug use», startet de fleste AAS-brukerne med narkotika, og at kun et fåtall av dem trente styrke. ...
This article presents a study of Norwegian prisoners’ experiences with anabolic-androgenic steroids (AAS) and other drugs. An intervention »Ren trening« was conducted by Antidoping Norge2 in the fall of 2019. Fieldwork was carried out at two drug treatment units with a total of 25 prisoners, 11 of which were interviewed. A bottom-up approach to the analyses of the data resulted in rich narratives that give a unique insight into prisoner experiences with AAS. Further analyses showed extensive use of AAS in combination with other narcotics, especially ampheta-mine. According to a typology developed by Christiansen et al. (2017), the uncritical use of AAS, without any consideration for its potential-ly serious side effects, can be understood as »YOLO – You Only Live Once«. Ambivalence surrounding the use of AAS, even if respect for clean exercise without the use of AAS is high, can be linked to pleasant experiences with these drugs. The body remembers these experiences and prisoners recall them with nostalgic undertones. The seriousness of the problems associated with the use of AAS, including criminal activity, indicates the importance of addressing these issues in prison.
... Furthermore, the study is the first national prison survey that included lifetime, pre-prison and prison use of AAS and other substances. The limitations of the NorMA study have been discussed in detail in previous publications (Bukten et al., 2020;Bukten et al., 2015;Muller et al., 2018). As the data collected were self-reports of both substance and AAS use, participants may over-or under-report previous and current use. ...
Background
Anabolic-androgenic steroid (AAS) use is associated with health problems and substance use. Substance use is common among inmates. This study aims to estimate lifetime and prison use of AAS and other substances, compare characteristics of groups of inmates, and describe factors associated with AAS use in a national prison population.
Methods
Data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of people in prisons, included sociodemographic variables and lifetime and prison use of AAS and other substances. Altogether 1,499 inmates, including 96 (6.4%) women, were divided into three mutually exclusive groups according to lifetime AAS use, non-AAS substance use and no substance use.
Results
Lifetime AAS use was reported by 427 (28.5%) inmates; 6 women and 421 men. Non-AAS substance use was reported by 593 (39.6%) and 479 (31.9%) had never used AAS or non-AAS substances.
Compared to the non-AAS substance group, the AAS group reported younger debut ages for nearly all non-AAS substances, higher mean number of non-AAS substances used in their lifetime (8.9, 6.6, p < 0.001), during the six months prior to incarceration (5.2, 3.1, p < 0.001), and during (2.3, 1.3, p < 0.001) imprisonment. Although 120 (8.0%) inmates used AAS during the six months prior to incarceration, only ten continued during imprisonment.
Conclusions
Lifetime AAS use is common among inmates and may be an indicator of more severe substance use problems. Screening for previous and present AAS use at incarceration and increased staff awareness are needed to tailor treatment approaches appropriately.
Introduction:
Methamphetamine use is more common than opioid use among prison entrants in some countries, including Australia, yet most research and policy focuses on opioid use. This suggests that traditional opioid-focused interventions are no longer appropriate for the majority of this group in countries such as Australia. To inform policy and practice, we compared socio-demographic characteristics and health needs of people leaving prison with a history of methamphetamine use and/or opioid use.
Methods:
A cross-sectional survey of incarcerated adults administered the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test was used to identify moderate-/high-risk methamphetamine use (n = 909), opioid use (n = 115) or combined methamphetamine/opioid use (n = 356) before incarceration. We compared groups using modified log-linked Poisson regression with robust error variance.
Results:
Compared to the opioid-only group, the methamphetamine-only group were: significantly more often aged <25 years; significantly more likely to identify as Indigenous; significantly less likely to have a history of prior incarceration, drug injection or overdose. A significantly lower proportion of methamphetamine-only and methamphetamine-and-opioid participants self-reported current hepatitis C infection compared to opioid-only participants. A majority of participants in all groups screened positive for current psychological distress according to the K10.
Discussion and conclusions:
People leaving prison with a history of methamphetamine use differ from opioid users with respect to demographics, patterns of substance use and related health concerns. Treatment and harm reduction efforts for people who experience incarceration must respond to patterns of drug use in this population, and invest at scale in coordinated, continuous services for co-occurring substance use and mental health problems.
Background:
Research shows that the prevalence of substance use disorders among the prison population is high globally. Although prisons are highly controlled environments, access to drugs and other substances in prison remains a major problem. Yet, previous research is focussed mainly on the Western context, with the studies generally reporting on lifetime prevalence without reference to whether the disorders are manifest even within the controlled environment.
Aims:
To estimate the prevalence of substance use disorders evident while in prison in Ghana and associated risk indicators. For these purposes, substance use disorder was defined by any indication of dependency, or escalating use or socially problematic use during the 12 months of imprisonment prior to the interview.
Methods:
The study involved 500 adults (443 men and 57 women) in a medium-security prison in Ghana who had served at least 1 year of a prison sentence. Participants' alcohol use disorder was assessed separately from other substance use disorders which included cannabis, cocaine and other stimulants using the Mini International Neuropsychiatric Interview (MINI); it is a structured interview and diagnostic tool for major psychiatric and substance use disorders in DSM-5 and ICD-10.
Results:
Two percent of the 500 participants had used alcohol to the level of alcohol use disorder, and 6% had other substance use disorders in 12 months prior to interview and while in prison. Cannabis (4%) and stimulants (3%) were the most frequently reported substance use disorders. Logistic regression model estimates indicate that younger age, prior offending and alcohol use dependence were significantly associated with such disorders in prison.
Conclusion:
In spite of efforts to prevent substance use in prison, nearly one in 10 of these prisoners were using alcohol or illicit drugs to a level indicative of substance use disorders. Our findings suggest that prioritising brief assessment may help identify those in most need of clinical help to limit their alcohol and illicit substance use problems.
The study explored the views of prison officer students and their supervisors regarding (1) prison officer education, (2) prison officers’ continuing professional development, (3) prison officers’ training needs and opportunities, and 4) the future of prison work. A total of ten interviews were conducted in a prison in Norway in October 2021.
The prison officer students who were interviewed expressed satisfaction with their education. Communication was highlighted as the most relevant learning topic. Regarding the continuing professional development of prison officers, learning about communication and mental health issues were expressed as areas of particular significance. Learning about services for female prisoners was also brought up. The issues that impede prison officers’ participation in training were the limited time to arrange training and the lack of financial resources.
The importance of collaborating and learning together with mental health professionals was expressed, but borrowing learning resources from the neighbouring disciplines was considered to be problematic because of the specific character of prison work.
The future of prison work was discussed from different viewpoints. The numbers of aggressive prisoners, old prisoners and those with mental health issues were expected to increase. The need to continue the development of prisons and concerns over the future role of prison officer were also expressed. The report provided five suggestions for future research concerning correctional services.
