Substance misuse within prisons and secure settings is not only a public health crisis but also a societal challenge with deep implications for individuals, families, and communities. The latest statistics covering the period between April 2023 and March 2024 underscore an urgent need to address rising substance use, strengthen treatment pathways, and focus on long-term solutions to eradicate addiction.
Substance Misuse in Secure Settings
Between April 2023 and March 2024, 49,881 adults received drug and alcohol misuse treatment in secure settings, a 7% increase compared to the previous year. This marks the third consecutive year of rising treatment numbers—a 14% increase from the recorded low of 2020-2021. However, figures remain significantly lower (17% less) than the peak reported in 2015-2016.
Substance Use by Group
Adults in treatment were categorised into the following substance groups based on their reported issues:
- Opiates (47%): By far the largest group in treatment, highlighting the prevalence of heroin dependency.
- Non-opiate only (21%): Representing individuals using substances like cocaine, cannabis, and synthetic drugs.
- Non-opiate and alcohol (20%): Combining non-opiate substances with alcohol misuse.
- Alcohol only (11%): Addressing issues with solely alcohol dependency.
Opiates remain a dominant concern, with 49% of those starting treatment reporting problems with opiate use. Additionally, 42% cited alcohol misuse—either on its own or in combination with other substances—while cannabis problems were reported by 31% and cocaine by 25%. The prevalence of these issues reflects the entrenched patterns of substance abuse among prison populations.
Gender and Age Disparities
Substance misuse affects men disproportionately, with men accounting for 91% of all adults in secure settings while women represent just 9%. Notably, women are overrepresented in the opiate group, where they make up 13%.
Age plays a crucial role too. Adults aged 30-49 dominate treatment numbers, constituting 67% of the total population. Those under 30 are more likely to be treated for non-opiate substances, while older adults (50+) report higher rates of alcohol-related issues.
Regional Disparities in Treatment Continuity
Continuity of treatment following release is critical for successful rehabilitation. However, only 53% of adults transitioning from custodial settings to community care started their treatment within three weeks—a slight improvement from 43% the previous year, yet still far from ideal.
Regional variations were stark, with the North West achieving the highest success rate in continuity of care (66%), while London had the lowest (41%). These gaps highlight inconsistencies in community care networks, leaving some individuals vulnerable to relapse during key transitional periods.
Injecting Drug Use
Injecting drug use remains a troubling indicator of addiction severity within prison populations. Among individuals in the opiate group, 14% were reported as actively injecting—much higher than other substance groups, where active injecting ranged from 0.5% to 1.2%. Alarmingly, 34% of the opiate group had a history of injecting, suggesting a cycle of chronic substance misuse that requires intervention.
Treatment Types and Effectiveness
Of the adults receiving treatment, 97% were engaged in psychosocial interventions—support techniques addressing behaviour and recovery plans. Nearly half (44%) of all individuals also received pharmacological support, especially those in the opiate (78%) and alcohol-only (28%) groups. This dual approach remains essential in managing chronic dependencies, even though long-term success varies across groups.
Treatment Outcomes
Outcomes for adults leaving treatment reveal challenging disparities. Of the 31,050 individuals discharged this year, only 38% completed their treatment free of dependence. Success rates were higher for individuals in non-opiate only (52%), non-opiate and alcohol (53%), and alcohol-only (57%) groups, while only 18% of those in the opiate group achieved independence.
Societal Impacts of Substance Misuse
The Impact on Families
Substance misuse in prison populations extends beyond the individual. Nine per cent of individuals starting treatment were living with children before incarceration, highlighting the ripple effects on family stability. For those separated from children, 28% reported their children as being in contact with social care, including under child protection plans or receiving early assistance.
The toll on children’s well-being is undeniable. Parental substance misuse creates lasting challenges, jeopardising health, education, and emotional stability—issues that demand attention from both judicial and healthcare systems to ensure family safety.
Mortality Rates in Treatment
Despite efforts within prisons, substance misuse remains a life-threatening challenge. Thirty-eight individuals passed away while in treatment this year, with those in the opiate group accounting for 61% of these deaths. Such data underscores the risks of addiction, particularly amongst individuals with prolonged heroin dependencies.
Naloxone, a treatment to reverse the effects of heroin overdose, was provided to only 54% of opiate users upon release—evidence of missed opportunities to mitigate risks, even as broader systemic solutions are needed to prevent dependency from taking root in the first place.
Substance Misuse Among Young People
The latest data also provides insights into young people (17 and under) treated in secure settings. A total of 566 individuals were in treatment, an increase from the previous year. Reflecting broader youth custody demographics, 93% were boys, with the median age at 17. Among girls receiving treatment, most were aged 15 to 16.
Cannabis tops the list of problem substances, with 92% of young people reporting issues. Alcohol misuse (25%) and solvent abuse (16%) follow, reflecting the worrying prevalence of readily available substances among this vulnerable population. Additionally, 48% of young people reported engaging in polydrug use, a pattern that places them at significant risk for health, legal, and social consequences.
Exits and Success Rates for Young People
Of the 370 young people discharged from treatment, 48% completed treatment successfully, marking the highest recorded rate since reporting commenced. However, 52% failed to complete treatment, with reasons ranging from transfers to other facilities to noncompliance. These figures underline the need for robust community support to ensure sustained recovery for young individuals.
Building a Future Free from Addiction
The 2023-2024 data highlights the serious issue of substance misuse in secure settings. While there have been some improvements in treatment numbers and continuity of care, the widespread problem of addiction, particularly to opiates, remains a major concern.
The effects of substance misuse go far beyond prisons. Families are torn apart, children are put at risk, and entire communities feel the impact of unresolved addiction. Taking stronger action, alongside better education and prevention, could help break this harmful cycle.
Source: GOV.UK
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