Prison, alcohol and drug use

Australia has about 43,000 people in prison; with over 65,000 people going through the prison system each year.¹

Many people entering prison have poorer physical and mental health than the general population.¹

And, a large proportion have a history of alcohol, drug use and dependence.

Many also have co-occurring mental illness.¹

People in prison have often experienced social exclusion, disadvantage and trauma before being imprisoned.²

Compared to the general population, people in prison have higher rates of:

• housing instability and homelessness
• unemployment
• mental ill health
• chronic physical disease, such as diabetes, cancer, asthma and arthritis
• communicable diseases, such as hepatitis.¹

These factors increase the risk of drinking, drug use and dependence.

Australia’s alcohol and drug services reach less than half of those who need treatment - and these rates are even lower for people in the criminal justice system.³

Illicit and injecting drug use in prison

There are significant drug-related health risks for people entering and leaving prison.

While some people end up in prison for reasons related to their drug use, others may start their drug use in prison.⁴

Around 65% of people entering prison used illicit drugs in the past year, compared to 16% of those not in prison.^1,5

The most common drugs used are methamphetamine, cannabis, pain killers and sleeping pills.¹

People who inject drugs are also over-represented in the justice system.⁶

In Australia:

• half of people in prison have injected drugs at some point in their life
• two-thirds have injected drugs in the past year
• one in five people share injecting equipment while in prison, increasing the risk of hepatitis B and C.¹

Drug-related offending

Drug-related offences make up much of the work of police, courts and prisons. Many of these offences are for personal drug use and possession.⁷

One way to address this is decriminalisation.

Decriminalisation involves removing the criminal penalty for using or possessing small amounts of illegal drugs.

A fine and drug education or a treatment program is given instead of a criminal conviction.

Decriminalisation can:

• reduce costs and burdens to the criminal justice system
• remove the negative consequences of minor drug use and/or possession, such as stigma
• improve access to treatment for people experiencing dependence.⁸

Drug courts also support people with alcohol and other drug dependency in the criminal justice system.

They usually involve the person completing a drug treatment program. This might be while in the community, a residential facility or in custody.

Drug courts are proven to:

• reduce rates of re-offending
• reduce drug use
• improve access to treatment and health care.^9-11

Mental health, self-harm and suicide in prison

Many people in prison have both a mental health condition and substance use disorder.¹²

Around 40% of people entering prison have a diagnosed mental health disorder. And, many more go undiagnosed and untreated.¹

People entering prison are also more likely to have a history of self-harm and suicidal thoughts:

• 21% of people in prison have attempted suicide at some point in their life
• 44% have a history of suicidal thoughts
• approximately half of those who die from suicide in prison have had a history of self-harm.^{1, 2}

This puts them at increased risk of self-harm and suicide while in prison and once released.³

Many people who experience mental health issues, self-harm or drug dependence don’t seek help.²

Prisons provide an opportunity for health and support interventions, including identifying people with mental health and drug use issues and providing treatment.²

Treatment in the prison system

In the past 10 years there’s been a 56% increase in the number of people entering the Australian prison system.¹

Prisons are often over-capacity, meaning people are sometimes moved from one prison to another. This can make providing treatment and continuous care difficult.¹

Treatment options differ between each state and territory and national programs such as Medicare or the Pharmaceutical Benefit Scheme (PBS) often aren’t available. This can be particularly difficult for someone who’s receiving alcohol and other drug treatment.

People receiving treatment or medication before going to prison don’t always have access to these supports once they are imprisoned. This can leave them waiting for medication, leading to issues such as withdrawal or mental health instability.¹

Only 13% of people leaving prison in Australia have accessed alcohol and other drug (AOD) treatment in prison.^1,12

This lack of access to health care and AOD treatment increases the risk of:

• overdose
• self-harm
• suicide
• poorer health outcomes.^1,2

Improving post-release care

To help prevent the cycle of imprisonment, better support is needed for people while they’re in prison and once they’re released.

This includes improved health care, secure housing, education and employment.⁶

Currently 50% of people leaving prison expect to be homeless once released.¹

People who have managed to stop their AOD use in prison will often use again once released.6, 11 And, they’re also at high risk of overdose – particularly in the first few weeks following release.³

Around 42% of people leaving prison will reoffend and be reimprisoned within six-months of release.13 This rate is significantly higher for people with a history of substance dependence.¹³

There are many factors that increase the risk of re-offending, including:

• homelessness
• inadequate social support
• unemployment
• chronic health problems.¹³

Help and support

• Australian Community Support Organisation (ACSO) provides a range of alcohol and other drug treatment programs and services available for people engaged with the criminal justice system.
• Contact the National Alcohol and Other Drug for advice and support on 1800 250 015.