Written evidence submitted by Change Grow Live (TDP0011)

We have contributed to, and support, the evidence that Collective Voice, the alliance of voluntary sector drug and alcohol treatment and recovery providers, has submitted to this Justice Committee Inquiry on ‘Tackling drugs in prisons’. However, as the UK’s largest provider of drug and alcohol support services, we feel that Change Grow Live is well placed to provide our own insights.

Change Grow Live (CGL) is the UK’s largest provider of drug and alcohol support services. As a leading national health and social care charity, we provide drug and alcohol treatment services in 24 prisons and deliver three Dependency and Recovery services for men on probation across the country. Our 52 adult community substance-misuse services also support people engaged with the criminal justice system, for example, providing continuity-of-care from prison to community treatment and supporting those on community sentences (e.g. Alcohol Treatment Requirements [ATRs] or Drug Rehabilitation Requirements [DRRs]). We have experience of working with a range of partners including prisons, police, probation, courts and other stakeholders to deliver successful, equitable services for people engaged with the criminal justice system, underpinned by our organisational mission, ‘Believe in People’. We welcome the opportunity to further support the Inquiry in discussing or providing further information on any aspect of our submission.

Scale and Impact

1. What is the current scale of drug use in prisons in England and Wales?

Our response here is collated from, and informed by, incidental conversations of personal experiences with prisoners accessing our support via prison estate and community services. Change Grow Live staff also attend various criminal justice forums and meetings in a professional capacity with colleagues and partners from prisons, probation and other criminal justice support services regularly debating and informing service, systems and provision.

“Boredom”, “lack of purposeful activity”, “lack of regime”, “22hr lock downs”, “bullying”. These are some of the stark responses from staff experienced in direct service delivery in response to what they think are the factors driving the demand for drugs in prison. These situations are further compounded where there are low numbers of experienced Prison Officers within teams creating challenges of upholding ‘boundaries’ in behaviours and systems.

Listening to prison staff, the risks relating to the changes of drug culture and drug use are greater now than they’ve ever been. These include challenges related to accessibility and how drugs are getting into prisons including the use of drones, etc. 

There is also the growing challenge of drugs being “cut” with substances that are creating increased physical and mental dependency. These ‘drugs’ are harder to test, potentially cheaper to make/buy, and the unknown strengths increase risks related to overdose.

The lack of reliable testing for Psychoactive Substances (PS), combined with the ease in which PS and Synthetics can be conveyed and smuggled into establishments means that traditional drugs are incredibly scarce. Recently cannabis has worked its way back into the system, predominantly via drone conveyance, but PS is by far the biggest prison drug.

In our experience it appears there is an alignment of New Psychoactive Substances (NPS) with prison use that we don’t/did not see in the community and consequently Spice is not the issue in the community that it is in prison.

2. What impact does the presence of drugs have on the mental and physical wellbeing of prisoners, particularly vulnerable prisoners or those not previously involved in illicit activity?

We know that drug use in prisons is widespread, and inspections find that it is common for up to half of prisoners to be using drugs, with a considerable proportion of these only developing a problem after arriving in jail.

There are many issues to address here that impact negatively on individuals and further contribute to the environment of stigma related to drug dependency.

Situationally, the over-powering presence and availability of drugs and constant negative influence and associations due to cell lock-downs, etc. creates a situation where it is far easier to access drugs but ‘escape’ from drugs can be overwhelmingly challenging for both the prisoners and systems.  Issues here, for example, include access to/availability of ‘prison space’ over ‘rehab requirements’, meaning it’s a logistical challenge to enable access to Incentivised Substance Free Living (ISFL) or Therapeutic Communities (TC).

Debt, violence, self-harm are absolutely linked to drug use in prison. Not paying these debts, for example, can have consequences like bullying, blackmail, and violence which have detrimental impacts that can lead to increased vulnerabilities and create constant fears for prisoners concerned about their personal safety. Unfortunately, in our experience, this can lead to serious consequences including self-harm and suicide.

3. What is the impact of drugs on the safety of the prison environment for prisoners and staff?

The risks to the safety of staff and prisoners relate to the management of the availability, accessibility and distribution of drugs in prison as well as the health impacts to both.

The illicit prison economy is well established within prison estates with the control/management of the drug supply having an impact on prison regimes with the supply chains being well documented as being unpredictable and violent. We hear from colleagues and prisoners experiences that there are instances of individuals are being coerced into ‘testing’ drugs as an action to manage/pay back drug debts – and this ‘method’ of testing being treated as ‘entertainment’ for other inmates. It is also widely acknowledged that they will use those ‘in debt’ to them to gather debts from others, hold weapons, attack staff, move and destroy CCTV cameras , for example. The dealers themselves rarely hold the illicit items, meaning that they are often untraceable. However, some people with a long time to serve think they have nothing to lose and will take a “hit” or “an action” to wipe out part of their debt.

We hear people’s personal stories about how these ‘debts’ can have a negative effect on families and loved ones with common experiences including the coercion of sexual favours, smuggling and cuckooing occurring to a debtor’s family.

There is some evidence about the impact of stigma when re-engaging in drug treatment services that potentially has a negative impact on taking up support.

We have heard from sources within prisons about incidences of staff being affected by NPS being present/used in the establishment (e.g. secondary / involuntary contact), leading to medical issues.

Tackling demand

8. How effective are existing measures, such as substance-free wings, in tackling the demand for drugs in prisons?

We fully support the use of existing measures that will enable the tackling of the demand for drugs in prison and the recovery support for those who want to access it while in prison. However, we find from experience that these resources and delivery are often untenable where there is not unequivocal ‘buy in’ from the HMP Governors and the Senior Leadership Teams.

The effectiveness can also be influenced by capacity issues that have a detrimental effect on opportunities to fully embed the model.

In our experience, any Service User (SU) actively looking to reside on the ISFL tends to exhibit more controlled behaviours, want to live substance free, and engage with the regime. Officers who control wing movements are often reluctant to lose easy to manage offenders and replace them with SU who have been removed from the ISFL for displaying violent behaviour, or being under the influence, or drug dealing for example.

Over population also causes issues and we often find that a prisoner has been “housed on the ISFL, as there is nowhere else to put them.” This can happen when someone has been ‘ghosted in’ (removed from one prison and transferred to another, outside the usual movement process) and this can cause further issues and disrupts the community aspect of the work that takes place there.

Prisoners have been known to initiate a move to ISFL’s under the pretence of accessing recovery support to sell drugs, which immediately ruins the culture there, and can disrupt any progress made. 

9. What impact does drug testing have on reducing demand in prisons, and to what extent is HMPPS’s current approach to drug testing effective?

The current testing kits for ISFL’s use test for amphetamine, benzodiazepines, cannabis (THC), cocaine, methamphetamine and opiates. However, the drug most prevalent prison estates is spice and testing for this is difficult. Prisoners who smoke spice can often pass a drug test due to the time between use and testing taking place. This can cause challenges on the ISFL as prisoners know that they are potentially able to smoke spice regularly in their cells but still pass drug tests.

10. What role should prison governors and staff play in identifying and addressing drug misuse?

In our experiences the staff’s primary focus in prisons is on the regime and maintaining security. This focus, alongside current capacity issues, means that a rehabilitative approach is often a secondary measure. Staff need to be proactive in supporting engagement in treatment, enabling routes into treatment and addressing issues that create negative influence.

Lack of awareness and training for officers around substance misuse is evident especially when dealing with people who are under the influence. It appears there is an acceptance that it is just part of prison life.

We feel that a robust, joined up approach from Security, Drug Strategy and Safer Custody that reports into the Senior Leadership Team would support understanding of, and positive rehabilitative approaches. This can be addresses with better understanding and communication between staff teams and with defined direction or action plans from the prison Drug Strategy.

Support for prisoners

11. To what extent is drug treatment and healthcare in prisons effective?

• To what extent are there sufficient resources and trained professionals to support prisoners with their recovery?

Teams do well with the resources they have but services are continually stretched. With adequate capacity and resources activities such as regular one–to-one interventions, social prescribing of therapeutic sessions such as gardening for example, would be more effective in providing support for recovery.

Funding for clinical psychology to provide professional oversight on casework would also be beneficial in ensuring interventions are well targeted.

When recruiting staff we assess transferable skills that fit the role, but there is a need for level 3 or higher substance misuse courses so we can continually address individuals CPD against Danos competencies. This would enable well trained, knowledgeable and competent support workers to further develop within their roles with opportunities for their career progression while enabling quality support for users of the services. A national accreditation scheme for Recovery Workers would also give recognition and value to the profession, and in turn would increase staff morale and retention.

• How effective are screening tools in identifying individuals with drug-related issues at the point of entry?

Prison Healthcare complete a full healthcare screening on reception intake. If any drug or alcohol issues are identified at this point a referral is made to drug and alcohol services. However, we know people entering the prison system do not always disclose drug or alcohol issues on arrival, especially in the remand prisons, as they can feel this may negatively impact them at court hearings.

Change Grow Live staff also complete an induction session for every individual who enters the prison, remand, or training, where we are commissioned to provide services. We introduce our services and anyone requiring support with a drug or alcohol issue can self-refer.

Referrals are also made via various departments during a person’s sentence e.g. suspected under the influence, mandatory drug testing, adjudication process at some sites and OMU if there is a history of drug/alcohol related offending. 

Our outreach workers have been effective at engaging with people less formally on the wings where they have had opportunities to do so, who may have not actively sought out our services but may still need support.

•  How effective are current practices for the continuity of drug treatment services post-release?

We have a robust Connecting Communities service that has an excellent record of joined up working with most community providers. Partnership working with Probation has improved although the effectiveness of Probation Notification Action Planning (PNAP) is questionable. The Chain of Custody (COC) process has been slow to implement but prison in reach workers are now coming into custody to meet with service users before release. This is key process in enabling the building of trusted relationships during a crucial time. Local Authority Commissioners have been supportive and introduced a travel fund that is utilised for anyone in the local areas.

Where community treatment providers work within the prison estate the ability to build therapeutic relationships prior to release for the individuals creates opportunities for ongoing engagement on release. Activity such as gate pick-ups has been motivational and supports a willingness to seek further help on release helpful to remaining in structured treatment. However, this is more difficult when release areas are geographically further away. A more streamlined approach with Probation, Reconnect, and drug and alcohol recovery services would help improve processes.

Last minute changes to release area create challenges in ensuring continuity of care, and when people are released homeless this is largely unachievable.

We find community services in general do not prioritise prison leavers which can result in them being given essential appointments a long time after release which is difficult for them to navigate.

Revolving door service users have told us of the challenges they face with engaging with the community offer. They have increased difficulties in engaging as they do not find the offer appealing to people who have been in the system for long periods. This may result in a refusal to engage after initial appointments.

Accessing housing and provider services continues to be problematic. Housing providers work alongside the Connecting Communities team and despite this partnership connection the practicalities for staff and services users means long days are often spent sitting in local authorities waiting for temporary accommodation.

12. What improvements can be made to the commissioning and delivery of drug treatment services to ensure better outcomes?

Drug and alcohol services are not purely a healthcare intervention but need to work holistically with other services/interventions to support individuals to build their recovery capital. There are cross overs in relation to prison SMS but no clarity or consistency in where we should sit. For example, some contracts sit under the reducing reoffending umbrella whilst the majority are integrated healthcare services. Separate commissioning in our own right, and not as a sub-contractor, will give us far more autonomy and potentially access to additional ‘in-house’ specialist support services, and is key in progressing drug recovery and treatment .

Greater alignment with community provision is also essential in progressing holistic and consistent services. Strategic oversight and attendance/visibility of commissioners (both prison and LA) within key influencing groups would assist to better align strategic goals and objectives. Enhanced support and direction from commissioners could support practicalities in joined up sentence planning, supporting continuity of care and recovery/rehabilitation planning. It could also improve strategies to address stigma of engagement in treatment/staff culture and view of substance misuse, all of which can be challenging to overcome.

13  Overall, what progress has been made to date on implementation of the Government’s 10-year ‘From Harm to Hope’ drug strategy in relation to tackling drugs in prisons?

There has been very little focus on prison drug and alcohol treatment as part of the Government’s drug strategy and indeed it’s delivery. Community services have had significant funding uplifts but very little, if any, of that investment has made its way into enhancing the resources of prison treatment services.

Drug challenges and trends within prisons are distinctly different to in the wider community and more targeted and focussed investment in prison-specific services would help address this.

Drug use in many prisons continues to be prolific and new approaches need to be tested to address these significant risks.

January 2025