Prison services in the United Kingdom are managed by three separate administrations: England and Wales, Scotland and Northern Ireland. Drug strategies from each of the three administrations aim to reduce the supply of and demand for illicit substances, while also focusing on the treatment and recovery of prisoners with substance misuse problems.
Survey data suggest that the majority of prisoners have used illicit drugs prior to imprisonment and about one quarter have used drugs during their current term of imprisonment. Cannabis is the most prevalent drug used both outside and inside prison; other illicit substances, such as heroin and benzodiazepines, are also commonly reported to be used in prison. The use of NPS, in particular synthetic cannabinoids, has recently become common in some English prisons, and survey data suggest these substances are now more prevalent in prisons than heroin. Use of NPS, in particular synthetic cannabinoids, has been associated with recent increases in violence, self- harm incidents, presentation to emergency departments and deaths in prison, as well as mental health issues, medical emergencies, debt, bullying and intimidation. The Psychoactive Substances Act 2016 made it an offence to be in possession of a substance capable of producing a psychoactive effect (with exceptions) in a custodial institution.
Across the United Kingdom, responsibility for healthcare provision in prisons lies with the health services. Prisoners have access to a range of treatment services for substance use problems, including clinical services such as detoxification and OST, structured psychosocial interventions, case management and structured counselling. Blood-borne viruses (BBVs) remain a cause for concern; to improve the detection, surveillance and management of these infections, a new programme of opt-out BBV testing was introduced in England in 2014. Take-home naloxone is widely available in Scotland for prisoners who are at risk of opioid overdose on release and is becoming increasingly available in England and Wales. There is a focus on continuity of care in the transition between community and prison and vice versa. Drug recovery wings/units have also been piloted in England, Wales and Northern Ireland.
Use of NPS, in particular synthetic cannabinoids, has been associated with increases in violence, self-harm incidents and deaths in prison, as well as mental health issues, medical emergencies, debt, bullying and intimidation