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Prison and drug use: management, costs and criteria Enhancing prevention and treatment and promoting alternative measures

Expert Workshop

Lisbon -

A workshop involving leading experts from different countries to discuss the economic, social and health costs of drug-related incarceration in Europe has been organized in Lisbon on 23 September 2015 by the United Nations Interregional Crime and Justice Research Institute (UNICRI). The international symposium is part of the programme of the First European Conference on Addictive Behaviours and Dependencies, organized by the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) and the Portuguese Government. Representatives from the World Health Organization (WHO), the National Drug and Alcohol Research Centre of the University of New South Wales, Australia, the Association for Health Professionals in Prisons (Co.N.O.S.C.I.) and the Council for Social Sciences (CSS) from Italy will address the impact of drug control policies on prison costs, as well as the need to establish evidence-based criteria to assist the criminal justice sector in facilitating access to non custodial measures for persons with substance use disorders (SUD). Health management in prison will be also discussed, including the need to increase access to treatment and risk reduction measures, as means for reducing morbidity and mortality.

According to WHO, over 2 million people are imprisoned in penal institutions in Europe, at any given time. Worldwide, from 2% to 56% of these prisoners inject drugs. Evidence shows that incarceration can exacerbate physical and mental health conditions through factors such as limited access to sufficient health care, overcrowding and poor nutritional and hygienic conditions. Rates of relapse, psychiatric and infectious co-morbidity, and overdose mortality are much higher among people with a substance use disorder not treated in prison, than among the general population. In addition to the above, violence, stigma, lack of trained staff, isolation of prison health services from public health and lack of alternatives to imprisonment are all factors that may impede the effective management of persons suffering from substance use disorders who are sentenced to prison.

Prevention, treatment and risk reduction interventions in prison as well as non custodial measures have been shown to be effective in reducing morbidity and mortality associated with drug use, as well as in mitigating the social and health consequences of returning people with substance abuse disorders and related diseases back to society after serving prison sentences. However, insufficient financial resources, prison organizational and structural challenges as well as a criminal justice approach prevailing over a public health perspective have made it difficult to implement these interventions in prison settings, as well as to evaluate their cost effectiveness.

Diverting drug offenders from prison to treatment has been addressed in various ways by governments worldwide, and these approaches have been integrated and organized within national criminal justice systems. The effective implementation of alternative measures to incarceration for drug offenders in need of treatment poses several challenges. However, the international community has developed many instruments to enable countries to implement a comprehensive, sustainable and gender sensitive strategy, based on human rights and international instruments such as the UN Standard Minimum Rules for the Treatment of Prisoners, the Basic Principles for the Treatment of Prisoners and the UN Rules for the Treatment of Women Prisoners.

During the meeting the results of the research conducted within the EU-funded AliceRap project will be presented. The research analyzed the relationship between policies and costs related to substance use and addiction occurring in the public health and the criminal justice sectors in Poland, Portugal and Spain. The symposium aims to promote a better understanding of the impact of drug control policies on prison costs and the development of evidence-based criteria to assess drug addiction, in order to support the criminal justice sector in facilitating access to non custodial measures for people with SUD, through better coordination mechanism and management in prison settings.

For more information please contact UNICRI: Alice Rena,, Alessandra Liquori O’Neil,

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