Harm Reduction In European Prisons

The key aim of this research was to provide an overview of the legislation, policy and practice concerning harm reduction services provided for problematic drug users (PDUs) in 9 European Union (EU) countries. To achieve this, the main objectives were to analyse international, national policies on harm reduction; to explore how harm reduction in conceptualised in different cultural contexts; to identify existing harm reduction initiatives in prisons; to identify the obstacles and barriers that need to be to overcome in order to implement harm reduction measures in prisons; to examine in detail the policies and harm reduction services in place in two sample institutions; to identify models of best practice and promote awareness of the harm reduction initiatives operating in the area of problematic drug users in custody, and finally to present examples of harm reduction measures in prisons from each of the sample countries. Key requirements needed in order to successfully implement sustainable harm reduction services in prisons are identified. These requirements can be formulated on all relevant levels: attitude towards and knowledge about harm reduction, drug addiction and health risks for all key actors, necessary changes both on the policy and practice level. Guidelines are formulated from evidence-based practice, as opposed to moral and value judgements. engl.

The Conference on "Prisons, Drugs and Society" was held in Bern from 20 to 22 September 200. The conference proceedings include 8 papers, presneted to the conference by delegates from different countries, including Vivian Stern from the UK, and Alexander Gunchenko from the Ukraine. The report concludes with a consensus statement agreed by the conference, on principles, policy and practice.

The rate of acute drug-related mortality, or overdose deaths, among prisoners in the immediate post-release period is unacceptably high. Such incidents result from many factors, including decreased tolerance after a period of relative abstinence during imprisonment and the concurrent use of multiple drugs which, with every additional illicit drug consumed in combination with opioids, nearly doubles the risk of death from opioids. Other important factors are the lack of pre-release counselling, post-release follow-up and failure to identify those at risk. Substance dependence is a chronic disorder with high relapse rates and often requires long-term continuous treatment. There is good evidence from trials and cohort studies that opioid substitution treatment reduces the risk of overdose among opioid users. This report identifies the main areas that need to be improved in order to decrease the risk of death. Linking prison health and public health systems closely is essential to mitigating this risk. Recommendations for preventive responses are considered across all levels of the justice system. The report includes a literature review that identifies a substantial body of research from various countries; this research supports the finding that the initial post-release period presents ex-prisoners with a significantly heightened risk of acute drug-related mortality.

This volume recognizes and addresses the health care issues of prisoners, to establish best practices and to learn about approaches to these challenges from around the world. It presents new evidence on several emerging and classical prison health issues. The first goal of this volume is to address emerging issues related to health in prison. Second, it presents the most recent research-based evidence and translates it to the practice. The third goal, is that it allows for sufficient diversity while also incorporating updates of some important already recognized prison health. The volume discusses prisons and the life and well-being of prisoners and staff, after growing problems as drug misuse (incl. tobacco smoking), infectious diseases (HIV/AIDS, hepatitis, STIs and TB), psychiatric problems, inadequate and unhealthy living conditions (incl. nutrition), overcrowding of prisons. These are addressed adequately in order to meet the international requirements of equivalence of health care. The scope of this volume is at the same type specific and diverse enough to cover the interests of a large audience that includes many types of practitioners involved in health-related issues in the field of prison health care, such as psychologists, nurses and prison administration officers responsible for health care, legal professionals and social workers.