Since 2006, the Länder have been legally responsible for administration of the penal system in Germany; as a result, some Länder had passed their own prison laws. The general German Prison Act from 1976 applies in the remaining Länder and regulates the execution of custodial sentences and the measures for rehabilitation and prevention.
Currently, there is no national data collection system regarding health in German prisons. Some anecdotal information indicates that drug use and related problems are more common among prison inmates than in the general population of Germany. Data on inmates who have been treated for drug dependence indicate that most clients request treatment because of stimulant or opioid use. A recent small-scale survey in two correctional institutions confirmed the anecdotal information regarding the use of NPS in prisons.
The medical care of inmates is funded by the Ministries of Justice of the Länder, but differences between the Länder exist in the regulations and legislation that apply to prisons. According to the World Health Organization indicator registry, the following types of drug treatment were available in German correctional institutions, albeit not in all Länder, in 2008: medication-assisted short- term detoxification, short-term detoxification without medication, abstinence-based treatment with psychosocial counselling, antagonist treatment and OST. In some Länder, OST was available only to inmates who had received it prior to imprisonment. Only six Länder provided additional psychosocial counselling in every treatment case.
Most Länder provide information material on the prevention of drug-related harms. Treatment for infectious diseases is also available. Condoms are available free of charge, but disinfectants are not generally available. One syringe distribution project exists (a syringe machine) in a women’s prison in Berlin.
A naloxone kit to prevent opioid overdose is provided by one pilot project to inmates who have completed the relevant training on their release from prison. In 2013, the Professional Association on Drugs and Addiction issued a recommendation on transition management, including recommendations for outpatient rehabilitation during imprisonment in a treatment centre outside prison that should be continued after release, on the need to establish links with community services and for provision of vocational training and drug emergency training sessions.
Medical care of inmates is funded by the Ministries of Justice of the Länder, and differences between the Länder exist in regulations and legislation