the prevalence of illegal drug use and drug related problems in

1、SPS Strategy on the Management of Drug MisusePathways and Progression: An Evaluation of Referral, Assessment, and InterventionDavid Shewan, Lisa MarshallGraeme Wilson, Gaby Vojt, Josie Galloway, Charles MarleyDepartment

2、 of PsychologyGlasgow Caledonian UniversitySCOTTISH PRISON SERVICEJUNE 2006Chapter One - IntroductionThe prevalence of illegal drug use and drug related problems in prisons in a number of countries has been widely repor

3、ted (British Medical Journal, 1995; Fazel, et al, 2006; Shewan and Davies, 2002; World Health Organisation, 2005). Substantial proportions of drug users in prisoner populations have been noted in many countries. Hiller

4、 et al. (1999) report that in the United States 68% of all new admissions test positive for an illegal drug in urine screening, and similar findings have been reported across Europe, North America, and Australia. ENDH

5、ASP (European Network of Drug and HIV/AIDS Services in Prison, 1997) estimated that 46.5% of prisoners across Europe would be users of illegal drugs prior to imprisonment. According to EMCDDA Annual Reports for 1999 a

6、nd 2000, between 15 and 50% of prisoners in the European Union have, or have had, problems with illicit drug use. In the United States this figure has been calculated as high as 70% (U.S Department of Justice, 2000). I

7、n Australia, Butler (1997) reported that 73% of female prisoners and 64% of male prisoners had used an illegal drug at some point, with 23% of females and 18% of males having used heroin (see also Dolan and Crofts, 20

8、00). In continents such as South America and Africa the situation is less clear, not least because of the lack of systematic research in these regions (Dunn, et al., 2000; Ohaeri, 2000). In Scotland, the most recent fi

9、gures show that 82% of the prisoner population had used an illegal drug in the twelve months prior to imprisonment, of whom 56% reported having used heroin. Overall, 27% of prisoners with a history of drug use in Scotl

10、and in 2004 reported having been in drug treatment prior to imprisonment (Scottish Prison Survey, 2004). To a large extent, this is something that is inherited by prison systems through the well- established link betwe

11、en drug use and crime (e.g. Bean, 2001), the high prevalence of problematic drug use among the Scottish population (Drug Misuse Information Scotland, 2005), and the steady increase in the number of people held in Scott

12、ish custodial establishments (Scottish Executive, 2005), and also prevailing criminal justice approaches to drug possession and supply (Maden, et al., 1992; Shewan, 1996a). It is unsurprising, therefore, that there is

13、 a concentration in prison of both those who promote illegal use of drugs and those who consume them (Stover, 2002; Tomasevski, 1992; World Health Organisation, 1992, 1993, 2005). From both a prison management and a p

14、ublic health perspective, it is concerning that there is evidence that drug-related problems can be exacerbated within prison. A recognised example of this is the initiation of drug injecting in prison (Gore, et al., 1

15、995), and increased risk of communicable diseases resulting from higher risk drug using behaviour. (Power, et al., 1992; Gore; 1995; Shewan, et al., 1994a, 1994b; Turnbull, 1991). Both of these issues represent a prio

16、rity for prison policy and practice (WHO, 2005). More typical than an increase in risk behaviours among incarcerated drug users in Scotland, however, is an overall reduction in quantity, frequency and range of drug use

17、, and a cessation in high risk factors such as injecting and sharing (Scottish Prison Survey, 2004, 2005; Shewan, et al., 1994a, 1995a). This represents an opportunity for the prison system to develop and maintain int