Substance misusers remanded to prison - a treatment opportunity?

Aims. To describe self-reported levels of substance misuse before arrest am ong remanded prisoners (unconvicted prisoners awaiting trial), to assess th eir degree of dependency on opiates and stimulants and to record their expe riences of treatment in prison. Design. Random selection of subjects from p risons chosen to give a geographical spread across England and Wales; self- report at semi-structured interview, plus examination of the prison medical record. Setting. Thirteen male prisons, three Young Offenders' Institution s and three womens' prisons. Participants. Nine hundred and ninety-five con senting, unconvicted prisoners, randomly selected from all locations within the prisons: 750 men (9.4% sample) and 245 women (82.2% of all remanded wo men). Measurements. CAGE Questionnaire, Severity of Dependence Scales (SDS) for daily users of opiates and/or stimulants. Findings. Before arrest, 145 (19.30%) men and 72 (29.4%) women had been dependent on street drugs; 91 ( 12.1%) men and 16 (6.5%) women were solely dependent on alcohol. Seventeen (2.3%) men and four (1.6%) women reported injecting drugs during this impri sonment. Mean SDS scores were 10.6 for opiate and 7.7 for stimulant users. 244 (25%) of all subjects described withdrawal symptoms on reception into c ustody; 157 (16%) reported being prescribed some symptomatic relief; 235 (2 4%) requested treatment at interview. Conclusions. By extrapolation, 1905 p eople-23% of all unconvicted prisoners-want treatment for substance misuse. This apparent shortfall in provision must be addressed; the rapidity with which remanded prisoners return to the community dictates that prison and c ommunity services should be closely linked.