Tackling Drug Misuse in Prisons

Mandatory drug testing (MDT) is routinely conducted in prisons and aims to support three key areas of His Majesty’s Prisons and Probation Service’s (HMPPS) drug policy within prisons: restrict supply, reduce demand and build recovery.

The study had three main aims:

1. To provide an understanding of how rMDT and SBDT are conducted in different prisons with varying levels of compliance to rMDT targets.
2. To understand the specific operational barriers to implementation of the policy and the staffing requirements required to do so successfully.
3. To track the experience of prisoners who test positive to drugs to understand the perceived utility and impact of sanctions and support on deterrence.

Data collection took place between July and October 2023 in six prisons of varying compliance to rMDT targets: non-compliant, mixed compliance and compliant.

Research Questions

1. How are the two mandatory drug testing regimens (rMDT/SBDT) carried out? Do they follow protocol, and if not, in what ways and for what reasons?
2. What are the facilitators and barriers to delivering a full drug testing regimen according to protocol from the perspective of prisoners and staff? Do these facilitators and barriers differ across prisons with full, mixed, and non-compliance to rMDT targets?
3. Where there are differences in current drug testing practices across the six sites, what are the drivers of these differences?
4. What resources, including staffing levels, are required for the drug testing regimens to be delivered according to protocol?
5. Are rMDT/SBDT perceived by prisoners and staff to deter prisoners from using drugs? Do these perceptions differ across prisons with full, mixed, and non-compliance to rMDT targets?
6. Are rMDT/SBDT perceived by prisoners and staff to facilitate prisoners who use drugs in accessing support services? Do these perceptions differ across prisons with full, mixed, and non-compliance to rMDT targets?
7. What sources of support are prisoners offered in each prison following a positive test?

Key Findings

Through thematic analysis, four main themes were identified that reflected the experiences and views of staff and prisoners on rMDT and SBDT. These were:

• The prison environment – the majority of staff and prisoners reported that drug misuse was widespread, and this posed serious harms for prisoners, staff and the wider prison community.
• Implementation challenges – a combination of staffing issues, testing delays and limited joint working were preventing rMDT and SBDT regimens from being implemented as designed.
• Perceived and potential benefits – staff and prisoners generally shared the view that the benefits of rMDT could be increased by a greater focus on individualised, supportive responses to drug misuse and on recognising recovery successes.
• Costs and unintended consequences - monthly rMDT targets were generally viewed by staff as negatively impacting wider efforts to address drug misuse, and the use of sanctions for prisoners who had received negative test results was often considered counterproductive.

Recommendations

• An effective rMDT regimen requires a consistent and integrated approach that is appropriately resourced.
• Improving the performance framework for drug testing to avoid unintended consequences can improve the usefulness of mandatory drug testing in identifying, deterring and addressing drug use.
• The potential benefits of mandatory drug testing could be better realised with a greater focus on personalised, tailored support and encouraging recovery.