What is the issue?
Drug use within prisons in England and Wales has been steadily increasing, posing a safety risk for both prisoners and staff alike. Drug use can contribute to violence towards self and others as well as to crime within prisons, undermining prison security, affecting prisoners' physical and mental health, and lowering a person’s chance at successful rehabilitation upon release.
The Ministry of Justice (MoJ) and His Majesty’s Prisons and Probation Service (HMPPS) have commissioned a research programme to tackle drug use in prisons. Within this research programme, there is a focus on evaluating two interventions:
- Drug testing regimens, either mandatory or voluntary, which are interventions meant to deter the use of drugs in prisons as well as identify prisoners in need of drug treatment; and
- Incentivised substance-free living (ISFL) wings, which constitute a relatively new approach to tackling drug use and supporting addiction recovery, and which are designated areas of prisons where prisoners can receive support and treatment to live substance-free.
Little is known about the impact and effectiveness of drug testing regimens on deterring and lowering drug use in prisons. Similarly, little is known as to whether ISFL wings can effectively reduce drug use, and if they do reduce drug use, how it is achieved.
How did we help?
The MoJ and HMPPS jointly commissioned RAND Europe to conduct a research study to examine and evaluate how drug testing regimens and ISFL wings are implemented in prisons in England and Wales. The research team developed three research strands to better understand the issues at hand:
- In Strand 1, the research team took a qualitative case study approach to three prisons and captured the lived experience of prisoners and prison staff to understand how drug testing regimens and ISFL wings were perceived and experienced.
- In Strand 2, the research team conducted a process evaluation of drug testing regimens in six prisons to understand the barriers, challenges and required staff resources to implement different drug testing regimens and what factors contributed to prisoners accessing support.
- In Strand 3, the research team conducted a process evaluation of an ISFL wing trial that was conducted in three prisons.
This study aimed to fill important gaps in the existing understanding of the implementation of drug testing regimes and ISFL wings in prisons.
What did we find?
In the Strand 1 report, ‘A qualitative study into the lived experience of drug testing and Incentivised Substance Free Living (ISFL) wings in three prisons’, key findings on drug testing regimens included:
- Drug testing regimens appear to be designed with limited consideration of the variation and uniqueness of each prison and its population.
- The illicit use of prescription medication, sourced through the prison’s medication hatch and traded among prisoners, was reported to be prevalent in all three sites.
- Drug testing regimens were not always seen to be effective as a therapeutic tool to support prisoners or address underlying needs that drive drug use.
- Most participants felt that drug testing was currently ineffective at deterring drug use, in part due to inconsistent implementation.
Key findings on the ISFL wings included:
- There were mixed perceptions about the value of ISFL across the prison populations.
- ISFL referral processes differed significantly in implementation across the three prisons.
- Approaches to dealing with positive drug test results from ISFL residents also differed across the sites.
- Talking therapies and purposeful activities were important in supporting recovery.
- The importance of a stable, safe environment and providing activities tailored to the needs of the population was highlighted by interviewees.
- Interviewees across the sites also commented on the importance of positive relationships between prisoners and experienced staff who work consistently on the wing.
- Lessons from two prisons point to some unintended negative consequences that must be managed.
In the Strand 2 report, ‘A Qualitative Study on the Implementation of Drug Testing in Six Prisons’, four main themes were identified that reflected the experiences and views of staff and prisoners on random and suspicion-based drug testing. These were:
- The prison environment: Most 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 drug testing regimens from being implemented as designed.
- Perceived and potential benefits: Staff and prisoners generally shared the view that the benefits of drug testing could be increased by a greater focus on individualised, supportive responses to drug misuse and on recognising recovery successes.
- Costs and unintended consequences: Monthly testing 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.
In the Strand 3 report, ‘A Process Evaluation of Incentivised Substance Free Living Wings in Three Prisons’, four main themes were identified that reflected the experiences and views of staff and prisoners on these ISFLs. These were:
- The ISFL environment: prisoners and staff reported that the spaces on the ISFL were clean, calm, and facilitated drug-free living.
- Prisoner and staff accountability: prisoners understood they had to abide by certain rules and norms on the ISFL to enjoy its benefits. Staff also reported that they were held accountable by colleagues and prisoners for their own attitudes.
- Building and maintaining relationships: the ISFLs facilitated the development of strong bonds amongst prisoners and between prisoners and staff.
- The identity of the ISFL: Perceptions of the ISFLs differed across the prison. Some staff and prisoners in other wings had negative impressions of the ISFL, often relating to stigmatisation of people who use drugs.
What can be done?
In relation to the effective implementation of ISFLs, key pieces of learning include:
- Creating and sustaining a sense of community in the ISFL is a cornerstone in forming a safe and stable environment for staff and prisoners.
- Having a balanced population on the ISFL of prisoners who are at different points in their recovery journey, and those without a history of drug use, provided prisoners with new insights and opportunities for personal growth.
- Working on the ISFLs can provide staff with opportunities for professional growth and a more rewarding experience at work.
- There is more work to be done, particularly amongst prison leadership, in raising awareness of the purpose and potential benefits of ISFLs to support progress towards desired outcomes.
In relation to the implementation of drug testing regimens in prison, key pieces of learning include:
- An effective drug testing regimen requires a consistent and integrated approach that is appropriately resourced.
- The potential benefits of mandatory drug testing could be better realised with a greater focus on personalised, tailored support and encouraging recovery.
- 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.
Read the research
Project Team
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