Aftercare For Drug-Using Prisoners: Lessons From An International Study
| Author | Anne Fox |
| Published date | 01 June 2002 |
| DOI | 10.1177/026455050204900206 |
| Date | 01 June 2002 |
| Subject Matter | Articles |
Prisoners: Lessons From
An International Study
Anne Fox discusses the results of research examining aftercare
provision for drug-using prisoners in four European countries. She
examines the differing attitudes towards drugs in each country and
the treatment models arising from them, concluding that the greater
the disagreement (professional, political and public) about the
underlying causes of drug dependence and its association with
offending behaviour, the greater the obstacles to successful aftercare.
In the summer of 2000, the European methodology developed by the World
Commission funded a rapid situational
Health Organization and the Joint United
assessment (RSA) of the state of aftercare1
Nations Programme on HIV/AIDS
for drug-using prisoners primarily in four
(UNAIDS) in conjunction with Professor
countries: Austria, Sweden, Scotland
Gerry Stimson, Director of the Centre for
and the Netherlands, with additional
Research on Drugs and Health Behaviour
comparative research conducted in England
(UK), to facilitate understanding and
and Wales (Fox, 2000). The aim of the
assessment of the extent and nature of the
research was to gain a broader perspective
drug, health and social problems in a given
of the methods, philosophies, problems and
area. The systematic data-collection
practicalities involved in post-prison
procedures yield quick information at
treatment, and to gather examples of ‘best
relatively low cost. In this study, the RSA
practice’ in aftercare.
team employed the following data-
This article will précis the findings of
collection techniques in the four countries:
this study and discuss the difficulties
•
Structured interviews and/or surveys
inherent in defining what is ‘best practice’
•
Informal interviews
in countries with widely differing attitudes
•
Observation
and beliefs about the relationship between
•
Focus groups
drugs and crime.
The fieldwork was conducted by the
author, who spent five to seven days in
Austria, Sweden and the Netherlands. Visits
Research Method
were hosted by key figures within the
Ministry of Justice, the prison and
Rapid Situational Assessment (RSA) is a
probation services and the key drug
120
treatment agencies responsible for
shown that well-managed aftercare
prisoners. Data gathered in these countries
programmes can significantly reduce
was mainly qualitative; interviews were
recidivism and relapse among drug-
conducted with:
dependent prisoners. (See, for example,
•
Ministry of Justice officials
Inciardi et al, 1997; Hiller et al, 1999)
•
Prison officials
Effective aftercare can break a cyclical
•
Probation officers
pattern of addiction and crime, or prevent a
•
Drug treatment agency workers
first offence from becoming a life template.
•
Social workers
Aftercare can help to break this cycle by:
Two days of each visit were left open to
1. Maintaining gains made by in-prison
follow up on leads gathered via
drug treatment;
‘snowballing’ techniques (widening the
2. Reducing the incidence of relapse;
sample by asking existing subjects to
3. Breaking the cycle of drug use and
recommend other key informants).
offending behaviour;
Wherever possible, the researcher
4. Providing prisoners with the social and
conducted interviews with prisoners or
practical skills necessary to survive on the
clients in rehabilitation centres.
outside without resorting to drugs or crime.
Unfortunately, both access and language
Aftercare can also save lives: statistics
often presented barriers to obtaining these
gathered over the past ten years show that
personal views.
the risk of death from overdose is higher
In Scotland, where time, access and
during the first two weeks after a prisoner’s
language were less of a problem, the
release than at any other time (Seaman
research focused exclusively on Barlinnie
et al, 1998). During their incarceration,
prison in Glasgow (Scotland’s largest
many heroin users either stop using or
prison). In September 2000 a questionnaire
maintain their addiction with lower-quality
survey focusing on experiences with
products. Either way, their tolerance of the
aftercare was conducted with a sample of
drug is reduced. After release, an injection
82 prisoners from Barlinnie’s Drug
of what they consider a normal dose may
Rehabilitation Unit; individual semi-
kill them. This problem is particularly
structured interviews were conducted with
apparent in Scotland: during 1996-1998,
20 of those prisoners. During a follow-up
prisoners who had been out for less than
study in February 2001, a further 64
three weeks accounted for 21% of all drug-
prisoners completed questionnaires. We
related deaths in Glasgow (HM Prison
also re-interviewed four prisoners who had
Barlinnie, 2000).2 The UK has one of the
been released since September 2000 to
highest rates of non-intentional drug-
assess their experiences with aftercare. Two
related deaths (involving opiates, cocaine
of them had been re-arrested in the period
and other stimulants and hallucinogens) in
and returned to Barlinnie; two were still
Europe; the Netherlands has one of the
free and met researchers outside of the
lowest (EMCDDA, 2000).
prison. Key staff such as social workers and
prison drug workers were also interviewed
during both phases of the study. In addition,
Reducing Crime
we canvassed the views and experiences of
several external drug service providers
In the past few years, the connection
around Glasgow.
between drugs and crime has been widely
debated. Although available evidence
The Importance of
confirms a link between dependency and
criminal behaviour (South, 1997)
Aftercare
determining causality between drug use
Longitudinal evaluation studies have
and criminal behaviour is far more difficult
121
(Parker, 2001). Nevertheless, it is clear that
Service has shown that prison has become
drug users have frequent contact with the
a part of life for certain segments of the
Criminal Justice System and, as a group,
population. The survey found that almost
commit more frequent crimes than other
50% of young prisoners said that they were
offenders (NACRO, 2000). Recent Home
not worried by the prospect of returning to
Office statistics confirm that over half of all
prison, and 75% felt that nothing could be
arrestees reported heroin use (Sondhi et al,
done to stop them from re-offending
2001). The cost of these crimes is clearly
(Loucks et al, 2000)
disproportionate to the number of
Our research among older prisoners in
offenders. Estimates suggest that in the city
HM Barlinnie in Glasgow found evidence
of Glasgow, 8,500 heroin injectors steal
of this same attitude. Many felt that
around £200 million worth of property
repeated sentences were an inevitable part
annually (Scottish Executive, 2000).
of life. The majority expected to spend at
In some areas, it is apparent that a
least a third of every year in prison. Out
prison sentence, far from being a deterrent
of a sample of 82, 80% had been in and
to further drug use and crime, actually
out of prison more than five times. Prison
appears to increase the chances that an
officials in Barlinnie were also acutely
individual will re-offend (Coid et al, 2000).
aware of the problem of recidivism.
For example, research with offenders in
Several officers dubbed repeat offenders
Kent revealed that a previous prison
“carousel prisoners” because, after being
sentence doubles the chances of re-
released, they were “always coming around
offending (Kent Probation Service, 1996).
again”. On release, prisoners who have
In Scotland, 48% of prisoners return to
served several sentences, often joke with
prison within two...
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