Naloxone Fiasco in Prisons is Costing Lives
Prisons are failing to provide opiate dependent prisoners with lifesaving drug on release despite clear recommendations from the government and Public Health England.
Uneven provision of the opiate blocker Naloxone by prisons is putting opiate dependent prisoners’ lives at risk and is representative of wider barriers to continuity of care during transition from custody to community, according to a new report produced by the London based drugs and alcohol charity Blenheim.
The report points to the high mortality rates of opiate dependent prisoners in the immediate post-release period, coupled with high dropout rates in community treatment services as symptomatic of critical failures in the system.
Blenheim argue that quality, supported transitions between custody and community for people dependent on drugs are now the exception rather than the norm, noting that changes to probation and wider funding cuts across the criminal justice system are undermining positive recovery work in prisons and the community.
Blenheim CEO John Jolly said:
“The immediate period after release is an absolutely critical moment at which drug dependent prisoners are at their most vulnerable to harm and relapse. It is imperative they receive support, care, and attention to assist their transition into community based services. Something as simple as providing Naloxone on release can drastically reduce risks of overdose but provision is patchy and this is totally inexcusable. Too many people are falling through the gaps and too many people are dying. It is essential the Government takes urgent steps to address these systemic failings.”
Blenheim’s report points to growing international evidence outlining that overdoses account for 85% of all deaths in the first week post release. Recent UK research also finds the first week after release from prison is the period with the highest risk of mortality, with drug-related deaths the main cause.
When it comes to community based treatment, the report highlights figures from the National Drug Treatment Monitoring System (NDTMS) which outline just 30.3% of adults who engage with substance misuse treatment whilst in custody engage with community-based treatment within twenty one days of release.
Blenheim argue that government changes to the probation provision since the 2015 Transforming Rehabilitation Act along with wider disinvestment in many areas across the criminal justice system is exacerbating an increasingly critical situation.
Key among Blenheim’s concerns is the depletion of funding for the Drug Intervention Programme (DIP) that previously provided mechanisms to ensure joined-up transitions from custody to community treatment programmes.
The report urges the Government to return to a fully funded and sustainable case management approach as it was under the DIP and urgent action across the prison estate to ensure the mandatory provision of Naloxone for at-risk prisoners.
Click here for Blenheim’s full report – Failure by Design and Disinvestment 2018 DIGITAL
Notes to the editor:
Blenheim is a charity that helps people struggling with alcohol and substance misuse across London by providing accessible support and help to end their dependency. We have a number of recovery services running across Bexley, Enfield, Hammersmith and Fulham, Haringey, Hillingdon, Islington, Kensington and Chelsea, Lambeth, Lewisham, Redbridge, Tower Hamlets, and Westminster. Each of these services provides free, friendly, and non-judgmental support, offering unique and tailored services to the individuals and their communities. For over 50 years Blenheim has been pioneering services and social action. As a charity, we are committed to innovating and campaigning for best practice and positive change in the alcohol and substance misuse field.
There is a growing international evidence base about the high risk of overdose and death of opiate using prisoners, in particular in the period immediately post-release. A recent large scale Norwegian study examined the deaths of all prisoners in the first six months of their release over a fifteen year period (1 Jan 2000 to 31 December 2014); the sample comprised 92,663 prisoners released a total of 153,604 times and the study found that overdose was the most common reason for death at every time period within the first six months post-release.
Drug Intervention Programme (DIP)
The Drugs Intervention Programme, was introduced by the Home Office in 2003 to engage Class A dependent drug offenders in treatment and was funded to the tune of £114,652,800 in 2007/8. The Home Office DIP funding ceased in 2013 with a much reduced level of funding picked up by health and wellbeing boards and community safety partnerships, varying considerably across the country. Again NDTMS figures are telling: the proportion of new treatment presentations referred by arrest referral/DIP reduced from 11% in 2013/14 to 3% in 2016/17.