Drugs in Prison: A Practitioner's Guide to Penal Policy and Practice in Her Majesty's Prison Service

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Steve Gravett

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    Copyright

    View Copyright Page

    List of Charts and Tables

    Foreword

    When I was asked to write the Foreword for this book, I was pleased to accept for two reasons. First, I believe the subject is one of increasing importance and second, my involvement was another example of the increasingly close cooperation between staff from the Prison Service and those from external providers of services.

    Since the publication of ‘Drug Misuse in Prison’ in 1995, the balance between the attempts to control the supply of drugs and the introduction of measures to increase access to treatment and reduce demand remains an issue to be resolved. Yet the willingness of those involved to engage in dialogue and work together towards common goals has been one positive outcome of the strategy to date.

    The publication of the Government's ten-year strategy, ‘Tackling Drugs to Build a Better Britain’ (April 1998), was swiftly followed by the second Prison Service drug strategy, ‘Tackling Drugs in Prison’. The strategy ensures that work with drug users in prisons is closely linked with interventions within the wider community. Interestingly, in that this is happening at a time when prisons generally are seeking to develop more solid links with the communities they serve, particularly with a view to strengthen the overall approach to tackling offending behaviour and reducing recidivism.

    My own organization, Cranstoun Drug Services, has worked with drug users in prisons since 1982. One of our main tasks has been to assist prisoners to make and maintain links with external agencies, particularly in respect of post-release treatment and support. This approach has now been more widely adopted through the development of CARAT services throughout the Prison estate. (CARAT stands for Counselling, Assessment, Referral, Advice and Throughcare.) Latterly, Cranstoun has also become involved in the delivery of treatment programmes and staff training within a number of prisons, but brief interventions and a brokerage function on behalf of prisoners remain our core business.

    The task of delivering drug services within prison presents additional challenges to similar provision outside. The recent massive development of prison-based services has exposed the lack of available, experienced practitioners to fill new posts. When staff are recruited, even those relatively experienced in service provision within the community, they require quality induction and support to enable them to adjust to work within the prison environment. A large part of this requires them acquiring knowledge of rules and systems, as well as developing an understanding of the culture of the prison(s) within which they work.

    In this book, Steve Gravett covers, in a user-friendly way, most areas in which drug services would expect staff to be competent. I think the book also provides a way for prison staff to locate their work with drug users within their overall duties. His approach keeps jargon to a minimum and, where it is used, he provides explanations in plain English. The way the book is structured makes it accessible as a work of reference. The sections on drugs and their effects and on prison rules and adjudication processes are good examples of this.

    Inevitably, any literature review for such a book must be selective, in view of the amount of works relating to prisons that have been produced. Steve has taken what I would describe as landmark publications, such as Woolf and Learmont, as well as using evidence from reports of HM Chief Inspector of Prisons, to chart progress in his chosen subject area. Some might take issue with his choice, but as a text for those new to the field, I think it describes adequately the framework within which developments have taken place. For those reading the book as an introduction to the work in prisons, the checklists at the end of each chapter provide a valuable aide-memoire to the learning process.

    Another strength is the use of the case studies. I think an important aspect of these is that they demonstrate the ordinariness of most prisoners and highlight the common issues they present to workers from helping agencies. Many of the needs that emerge are related to relationships and situations outside the prison and thus point to the need for a more holistic approach. To use the language of community care, the provision of seamless services, provided within a multi-disciplinary framework.

    Steve describes well the interventions now on offer within prisons for drug users. In particular, he describes the process by which prisoners can access the various interventions on offer. In this, examples of practice in various establishments are identified. If I were to have a criticism of this book, it would be that Steve fails to use examples of good practice that exist within HMP Camp Hill, where he is the Deputy Governor. Cranstoun staff have worked with prisoners in Camp Hill for many years and have generally met with a positive response from staff. My own involvement, principally with the prison management in the establishment and development of CARAT services, has been a rewarding experience. The support of senior management in any establishment is crucial to the sustainability of new services and I can say that this support is very real and effective within HMP Camp Hill.

    Most of the book is devoted to description rather than opinion. Where opinions are expressed, I am sure they will not be universally accepted. This is a healthy position, provided those seeking to argue or criticize do so constructively, with the aim of taking issues forward. Also, some might say that the book fails to cover some aspects of the work, or that it doesn't cover them in sufficient depth. These may be legitimate criticisms, if Steve had claimed this to be a definitive text. I think any such criticisms should properly be met with an invitation to the critic to improve upon the contents herein and thus advance the creation of a more comprehensive catalogue of information for those working with drug users in prisons.

    PaddyCostallDirector of Services Cranstoun Drug Services

    Preface

    Vision
    Aim

    Effective execution of the sentences of the courts so as to reduce reoffending and protect the public.

    Objectives
    • Protect the public by holding those committed by the courts in a safe, decent and healthy environment.
    • Reduce crime by providing constructive regimes which address offending behaviour, improve educational and work skills and promote law-abiding behaviour in custody and after release.
    Principles

    In understanding its work, the Prison Service will:

    • Deal fairly, openly and humanely with prisoners and all others who come into contact with us.
    • Encourage prisoners to address offending behaviour and respect others.
    • Value and support each other's contribution.
    • Promote equality of opportunity for all and combat discrimination wherever it occurs.
    • Work constructively with criminal justice agencies and other organizations.
    • Obtain best value from the resource available.

    The Prison Service will also encourage prisoners to address offending behaviour and respect others. We will run our prisons in such a way that prisoners are motivated to use their time in custody positively.

    We are committed to reducing re-offending through improved regimes for prisoners, by encouraging purposeful activity, through the improvement of educational and work skills, and through a wide range of offender treatment programmes.

    A large number of prisoners use controlled drugs both inside and outside prison. We are determined to achieve a reduction in drug use amongst the prison population, through treatment programmes for drug users, as well as improving security.

    The Prison Service VISION

    Acknowledgements

    My thanks to Martin Nary, the Director General of the Prison Service, who kindly gave me permission to write this book and reproduce several forms.

    I am grateful for the cooperation of the Prison Service College Library at Newbold Revel, in particular Catherine Fell and Rebecca Mann. I appreciate the advice and guidance of Richard Rossington from the Drug Strategy Unit in Prison Service Headquarters.

    Any views expressed in this book are solely those of the author and should not be interpreted as official Prison Service policy.

    How to Use This Book

    The Government's new drug strategy, ‘Tackling Drugs to Build a Better Britain’, and the Prison Service response, ‘Tackling Drugs in Prison’, herald a new era in drug penal policy. Major efforts are being made to resource this new policy on drug misuse. This strategy focuses on reducing the supply and demand for drugs in establishments, treatment programmes and seamless throughcare.

    This comprehensive handbook covers mandatory drug testing, voluntary testing units, drug trafficking, active and passive drug dogs, treatment, counselling, health care and support services, together with the new CARAT service. An evaluation of how well the drugs policy is being implemented in establishments can be gauged from recent reports published by Her Majesty's Chief Inspector of Prisons. These are carefully analysed in the penultimate chapter. Case studies and checklists help bring the text alive and reinforce key learning points.

    This user-friendly handbook complements my earlier book, Coping With Prison (1999), which is a comprehensive guide to penal policy and practice. Drugs in Prison concentrates on penal drugs policy and aims to be a comprehensive guide suitable for professional colleagues of all disciplines, students and prisoners alike. It contains valuable information for practitioners about drug misuse and focuses on current practice in a custodial setting. The pace of change in the penal field never ceases to amaze me. Inevitably some updating will be necessary as new legislation is introduced and policy is revised and amended in the light of experience.

    The male gender has been used throughout for ease of expression and consistency. Unless mentioned specifically, policy and practice is identical in the case of female prisoners and female staff. A comprehensive index has been included to allow key words and sections of explanatory information to be found easily. The appendix of documents gives examples of forms referred to in the text, and the glossary explains more fully the meaning of important terminology.

    This book is dedicated to the families of drug users, who suffer the terrible anguish of knowing that loved ones are ruining their lives, and know better than anyone how damaging drug taking can be to family life.

    Finally, a special mention to anyone who has benefited from life saving drugs and, in particular, received chemotherapy. Only they really appreciate the miraculous difference the skilful use of modern drugs can make to the quality of life.

    Any suggestions for improving this handbook will always be warmly welcomed by the author, who is now Deputy Governor of HMP Birmingham and can be contacted courtesy of the publisher.

    SteveGravett Autumn 2000

    List of Tables

    List of Abbreviations
    6-MAN6-monoacetylmorphine
    ADDActive Drug Detection
    ADDAttention Deficit Disorder
    ADHDAttention Deficit Hyperactivity Disorder
    AIDSAcquired Immune Deficiency Syndrome
    BCGBacillus Calmete-Guérin
    BoVBoard of Visitors
    CARATsCounselling, Assessment, Referral, Advice and Throughcare services
    CCTVclosed circuit television
    CNACertified Normal Accommodation
    CPSCrown Prosecution Service
    CSRComprehensive Spending Review
    DAATDrug and Alcohol Team
    DATDrug Action Team
    DCRDiscretionary Conditional Release
    DRGDrug Reference Group
    DRUDrug Rehabilitation Unit
    Eecstasy
    EMITEnzyme Multiplied Immunoassay Technique
    GNVQGeneral National Vocational Qualification
    GOADGood Order and Discipline
    GCSEGeneral Certificate of Secondary Education
    GS/MSGas Chromatography/Mass Spectrometry
    Hheroin
    HIVHuman Immunodeficiency Virus
    HMCIPHer Majesty's Chief Inspector of Prisons
    HMSOHer Majesty's Stationery Office
    IEPSIncentive and Earned Privilege System
    KPIKey Performance Indicator
    LIDSLocal Inmate Data System
    LSDLysergic acid diethylamide
    MDMAmethylene-dioxy-mentyl-amphetamine
    MDTMandatory Drug Testing
    MRCMedical Research Council
    NADNictinamide Adenine Dinucleotide
    NHSNational Health Service
    NVQNational Vocational Qualification
    OCAObservation, Classification and Allocation
    OSGOfficer Support Grade
    PDDpassive dog detection
    PEIPhysical Education Instructor
    PIPPrimary Intervention Programme
    ROTLRelease on Temporary Licence
    RTUReady-To-Use
    SAMHSASubstance Abuse and Mental Health Services Administration
    SARASubstance Abuse Referral Unit
    SIRSecurity Information Report
    SLAService Level Agreement
    SMARTSpecific, Measurable, Achievable, Realistic, Time-bounded
    TBTuberculosis
    THCTetrahydrocannabinol
    UKUnited Kingdom
    VPUVoluntary Prisoner Unit
    VTUVoluntary Testing Unit
    XTCecstasy
    YOIYoung Offenders Institution
    YOTPYoung Offender Treatment Programme
  • Glossary

    • Addiction is the compulsive use of a drug and is a chronic condition. It causes physical, social and psychological problems for which there are no known cures. Relapse problems can arise at any time as addicts frequently require further treatment.
    • Chemical deterrence Opiate dependence can be treated by trexan (Naltrexone). This drug interferes with the receptivity of the brain to heroin and stops it having any effect on the individual.
    • Chemotherapy This is where chemicals are used to treat cancer and the debilitating symptoms and side effects of a life-threatening illness. Methadone treatment involves substituting methadone for more harmful opiates such as heroin, as legitimate clinical practice.
    • Dependence When a drug is taken over a lengthy period of time, the body adapts to its presence in the body. Once the user stops taking the drug the body reacts with withdrawal symptoms. Dependence is treated by gradually withdrawing the drug over a period of time.
    • Detoxification This is the process by which addicts gradually withdraw from the drug they are addicted to under medical supervision. Sometimes this can be achieved using other less harmful drugs, as is the case with heroin addiction.
    • Intoxication describes how a drug affects the individual physically and psychologically. The effects of drugs can vary but are generally short-lived because the drug is rapidly broken down chemically in the body and eventually excreted. High doses can take several days to process and, if the quantity taken is excessive and overloads the body's coping mechanism, coma and death can result.
    • Methadone Heroin addicts undergoing detoxification are given methadone prescriptions and counselling. Users can be accepted on a reduction programme where the ultimate goal is to achieve total abstinence. Another option is a maintenance programme, which tries to minimize the impact of drug misuse on individuals and helps them to give up a self-destructive lifestyle. This programme also tackles social, physical and psychological problems connected with drug dependency.
    • Overdose Taking an overdose can lead to coma or death. An antidote exists for some drugs which counteracts the effects of the poison in the body. There is no antidote for other drugs and treatment consists of maintaining the body's essential life support systems until the drug has cleared from the body. Adulterated drugs often complicate the problem of dealing with overdosing and is common in many of the street drugs smuggled into penal establishments.
    • Relapse Prevention is the aim of most drug agencies. It is a regular occurrence with addicts who return to using drugs and then feel guilty for letting others down. Often they try to hide the fact that they have begun taking drugs again.
    • Sobriety This is the condition achieved following abstinence and implies a lasting change to an individual's lifestyle, values, attitudes and behaviour. Sobriety is the closest to a cure that can ever be achieved.
    • The twelve steps programme was originally devised by Alcoholics Anonymous in 1930 and published in their handbook called the Big Book. The twelve steps programme has been adapted by other self-help groups such as Gamblers Anonymous and Cocaine Anonymous. It has been used successfully by the Rehabilitation for Addicted Prisoners Trust (RAPt) at HMP Downview (see Chapter 8). The original twelve steps programme was set down as follows:
      • We admitted we were powerless over alcohol; that our lives had become unmanageable.
      • Came to believe that a Power greater than ourselves could restore us to sanity.
      • Make a decision to turn our will and our lives over to the care of God as we understood Him.
      • Make a searching and fearless moral inventory of ourselves.
      • Admitted to God, to ourselves and another human being the exact nature of our wrongs.
      • Were entirely ready to have God remove our shortcomings.
      • Humbly asked Him to remove our shortcomings.
      • Made a list of all persons we had harmed, and became willing to make amends to them all.
      • Made direct amends to such people wherever possible, except when to do so would injure them or others.
      • Continued to take personal inventory and when we were wrong promptly admitted it.
      • Sought through prayer and mediation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
      • Having had a spiritual awakening as the result of these Steps, we tried to carry this message to others, and to practice these principles in all our affairs.
    • Tolerance The body adapts to regular use of a drug so that larger and larger doses are needed to achieve the same effect. The danger of compensating by increasing the dose is the risk of overdosing.
    • Withdrawal This term is used to describe the process for treating drug dependence. It involves gradually reducing the drug dose over a period of time in order to counter the severe side effects of drug addiction.

    Appendix I: Documents

    Appendix II: Addresses

    This section contains a selection of useful organizations involved in helping those with drug dependency problems, and drug service providers to penal establishments.

    Acorn Community Drug and Alcohol Services, Frith Cottage, Church Road, Surrey

    GU16 5AD.

    Telephone 01276–670883

    A drug service provider to establishments.

    Addaction, Central Office, 67–69 Cowcross Street, London EC1M 6PU.

    Telephone 020 7251–5860

    A drug service provider to establishments.

    Adfam National, Waterbridge House, 32–36 Loman Street, London SE1 0EE.

    Telephone 020 7928–8900

    It runs a national helpline to support the families and friends of drug users.

    Avon & West Wilts Mental Health NHS Trust, Robert Smith Unit, 12 Mortimer Road, Clifton, Bristol BS8 4EX.

    Telephone 0117–973–5004

    A drug service provider to establishments.

    Cocaine Anonymous, telephone 020 7284–1123

    Provides a helpline for cocaine users.

    Compass, Kings House, 12 Kings Street, York YO1 9WP.

    Telephone 01904–636374

    A major drug service provider to establishments.

    Cranstoun Drug Services, 4th Floor, Broadway House, 112–134 The Broadway, Wimbledon, London SW19 1RL.

    Telephone 020 8543–8333

    Provides a range of specialist drug treatment and rehabilitation services catering for users in residential accommodation, prisons and the community.

    East Kent Community NHS Trust, Littlebourne Road, Canterbury, Kent CT1 1AZ.

    Telephone 01227–459371

    A drug service provider at an establishment.

    Exeter Drug Project, Dean Clarke House, Southernhay East, Exeter EX1 1PQ.

    Telephone 01392–666710

    A drug service provider to establishments.

    ISDD, Institute for the Study of Drug Dependence, 32–36 Loman Street, London SE1 0EE.

    Telephone 020 7928–1211

    Produces authoritative drug information in the form of leaflets, booklets and a bimonthly magazine.

    Kent Council on Addiction, DAN House, East Street, Faversham, Kent ME13 8AT.

    Telephone 01795–590635

    A drug service provider at an establishment.

    Life for the World, Life for the World Trust, Wakefield Building, Gomm Road, High Wycombe, Bucks HP13 7DJ.

    Telephone 01494–462008

    A Christian-based organization committed to helping with the rehabilitation of drug addicts into the community.

    Lifeline Project Ltd, c/o Psychology Department, HMP Wymott, Ulnes Walton Lane, Leyland, Lancashire PR5 3LW.

    Telephone 01772–421461

    A drug service provider to establishments.

    Mind, telephone 020 8522–1728 and 0345–660163

    Provides services for those suffering with mental health problems and drug users.

    NACRO, National Association for the Care and Resettlement of Offenders, 169 Clapham Road, London SW9 0OU.

    Telephone 020 7582–6500

    Provides information for prisoners and their families on a wide range of matters, including drug services.

    Narcotics Anonymous, telephone 020 7730–0009

    Provides a telephone helpline for drug addicts.

    National Aids Helpline, telephone 0800–567–123

    Provides a 24-hour helpline to those concerned about AIDS/HIV.

    National Drugs Helpline, telephone 0800–776600

    Provides a 24-hour helpline and advice to anyone concerned about drug misuse.

    Phoenix House, Phoenix House, 3rd Floor, Afra House, 1 Long Lane, London SE1 4PG.

    Telephone 020 7234–9740

    A drug service provider to establishments.

    RAPt, Rehabilitation for Addicted Prisoners Trust, 179–181 Vauxhall Bridge Road, London SW1V 1ER.

    Telephone 020 8976–6688

    Provides 12-step drug rehabilitation programmes in penal establishments.

    Release, 388 Old Street, London EC1V 9LT.

    Telephone 020 7729–2599

    Provides a 24-hour national legal and drug advice service.

    Samaritans, telephone 0345–909090

    Offers a 24-hour support and advice service to anyone in crisis and danger of self-harm.

    Shropshire Community Substance Misuse Team, St. Michaels House, St Michaels

    Street, Shrewsbury SY1 2HG.

    Telephone 01743–255741

    A drug service provider at an establishment.

    Terence Higgins Trust, telephone 020 7242–1010

    Provides a helpline for anyone concerned about AIDS/HIV.

    Trafford Substance Misuse Services, Chapel Road, Sale M33 7FD.

    Telephone 0161–912–3170

    A drug service provider to establishments.

    Turning Point, New Loom House, 101 Backchurch Lane, London E1 1LU.

    Telephone 020 7702–2300

    A drug service provider to establishments.


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