The General Secretariat of Penitentiary Institutions of the Ministry of Interior is responsible for prison administration in Spain, except in Catalonia. Healthcare provision in prisons is the responsibility of the Ministry of Interior, although in Catalonia and the Basque Country it is provided by the health services of these autonomous communities.
Drug treatment programmes in prisons are provided in partnership with various prison services (health, psychology, safety, etc.), and in close cooperation with available services outside prisons, such as drug treatment facilities, social services and NGOs. Three organisational structures in each prison are involved in the provision of these services: the commission on drug dependence, the sanitary team and the drug dependence team.
A 2011 survey on drug use among inmates in Spain reported that cannabis was the most common drug used in the 30 days prior to imprisonment (40 %), followed by cocaine (27 %), while heroin use was reported by 14 % of inmates. Injecting drug use was reported by 5 % in the 30 days prior to imprisonment, which was a decrease from 2006 (11 %). Cannabis was the drug most commonly used in prison (21 %), while use of other drugs was much lower and injecting drug use was reported by only 0.4 %. Polydrug use was common among drug users in prison. One third of those who inject drugs in prison are HIV positive and three quarters are HCV positive.
Health programmes implemented in prisons (treatment of HIV, HCV and tuberculosis, vaccinations and mental health) and drug-related intervention programmes — prevention, health education, health mediators (recruited among inmates), harm and risk reduction (syringe exchange, distribution of aluminium foil and condoms, overdose action programme) and treatment of the dependency (opioid substitution, detoxification) — have all contributed to reductions in morbidity and mortality among inmates in penitentiary institutions.
Methadone maintenance treatment constitutes one of the most effective intervention programmes in terms of risk reduction related to opioid use. It is an important part of drug treatment in Spanish prisons, and many drug users benefit from it.
The first needle and syringe exchange programme in a Spanish prison was introduced in Bilbao in 1997, and such programmes are now available in 47 prisons in Spain. The Bilbao programme received the First European Prize for Good Health Practices in Prisons awarded by the European Prison and Health Network of the World Health Organization (WHO).
Special social reintegration programmes offered in prisons provide drug users with the necessary skills to maintain treatment following release and support their reintegration into society.
In 2011, cannabis was the drug most commonly used in prison (21 %), while use of other drugs was much lower and injecting drug use was reported by only 0.4 %