Written evidence submitted by the Ministry of Justice and Department of Health and Social Care (TDP0030)

 

Executive Summary
 

  1. Drugs in prison pose significant challenges to offender rehabilitation, the safety of staff and overall stability of the prison environment. With nearly half (49%) of prisoners having an identified drug need, addressing both supply and the root cause and consequences of the issue is a priority for Government. The emergence of potent synthetic drugs, such as synthetic opioids, adds complexity to this challenge, escalating risks of overdose, and could increase the risks of violence and disruption. We face this challenge at the same time as considerable pressures on prison capacity, an ageing cohort of drug users, and record levels of drug-related deaths in the community.
  2. Successfully reducing the use of drugs in prisons is critical to breaking cycles of reoffending. Evidence has shown a 19-percentage point difference in the 2-year reoffending rates between those offenders who successfully complete substance misuse treatment, relative to those who drop out. Tackling the supply of drugs through robust security measures and reducing demand through targeted treatment and recovery support is central to addressing this crisis.
  3. Organised crime and the illicit market drive much of the drug trade in prisons. Tackling this requires robust collaboration with law enforcement to disrupt supply, investment in staff training and advanced security countermeasures.
  4. Additionally, high levels of mental health needs, significant trauma and social exclusion exacerbate drug use. Addressing these requires targeted interventions such as effective purposeful activity and person-centred mental health care.
  5. Dame Carol Black’s Review of Drug Treatment in Prison reflects the scale of the challenge, and while we have made progress by increasing the number of prisoners accessing treatment, introducing multiple countermeasures to tackle drug conveyance into prisons, such as X-ray body scanners and Enhanced Gate Security and improving continuity of care for those transitioning to the community, we recognise the need to go further and faster to change culture, increase the focus on recovery, ensure continued support for prisoners on release and tackle growing security threats such as drones.

 

Scale and impact

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

  1. There is a well-established and complex link between substance misuse and offending behaviour, with an estimated 44% of acquisitive crime committed by those regularly using heroin and/or crack cocaine.
  2. Almost half of prisoners (49%) in England and Wales in 2021 were identified as having a drug problem, impacting safety, rehabilitation and efforts to reduce reoffending. Moreover, we know that the prison drug economy is underpinned by serious and organised crime, which represents a significant threat to the stability of the prison system.
  3. In addition, in the 2022/23 HMIP report 8% of men and 9% of women reported that they had developed a problem with illicit drugs since being in custody. This highlights the urgency of addressing not only the supply of drugs, but also the environmental factors that drive demand within prisons.

 

What are the primary factors driving the demand for drugs in prisons?

  1. Many prisoners arrive in prison with a pre-existing drug need. The Ministry of Justice and health partners are working together to increase and strengthen the use Drug Rehabilitation Requirements as part of community sentences, diverting offenders away from custody and into treatment where appropriate. We know that for those who do receive a custodial sentence, demand for drugs is driven by a combination of interrelated factors. Poor mental health and previous trauma, which are prevalent in the prison population, can be an underlying cause of drug problems, and insufficient access to purposeful activity, which can provide focus and alleviate boredom, can exacerbate this.
  2. Our approach focuses on addressing these challenges through investment into effective drug treatment alongside mental health support, purposeful activity and security to tackle drug smuggling which is becoming increasingly technologically advanced, aligning with Dame Carol Black’s recommendation for a multi-disciplinary approach to substance misuse and mental health.

 

To what extent are new psychoactive substances and synthetic cannabinoids a growing challenge compared to traditional drugs?

  1. New psychoactive substances and synthetic cannabinoids pose a significant risk to prisoner wellbeing and prison stability. The initial influx of synthetic cannabinoids into the prison estate over a decade ago caused significant risk to life, the wellbeing of people in prison, and prison operations. These substances pose an ongoing threat, which we continue to address.
  2. We have increased our capability to detect for synthetic cannabinoids to include other emerging new substances. Every prison has trace detection machines to identify drugs in post or on clothing, and mandatory drug testing have been expanded to cover the most common synthetic cannabinoids. In addition to this, we are running wastewater surveillance pilots to identify new substances, bolstering mandatory urine testing with advanced detection tools, and training dogs to improve their ability to detect synthetic cannabinoids.
  3. We are also working to minimise the risks posed by the emerging threat of synthetic opioids (e.g. fentanyl, nitazines). Naloxone, a medication to reverse opioid overdoses, is being rolled out across all prisons and is currently live in 76. We are also raising staff awareness of synthetic opioids and how to respond, as well as
    collaborating as a part of a cross-government taskforce with health and enforcement partners to monitor risks and develop our response.

 

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?

  1. The presence of drugs in prison has a significant impact on safety and wellbeing of prisoners and staff. In addition, prison healthcare services have observed increases in emergency calls, and a growing number of ‘under the influence’ and overdose events requiring healthcare attention and monitoring. This diverts services from routine delivery and absorbs resources otherwise engaged in activities which contribute to prevention, rehabilitation and health education. Dame Carol Black highlights the need for purposeful activity, mutual aid and access to appropriate mental health treatment.
  2. Recognising its importance, we will continue to provide meaningful ways for prisoners to spend their time, to avoid demand driven by boredom, and incentives that motivate people to abstain. We want to ensure that the prison environment and culture are conducive to treatment and rehabilitation through structure, routine, and activities such as training. We are also focused on supporting access to mental health services and support for neurodiverse needs.
  3. We are committed to ensuring prisoners can benefit from mutual aid and are working with a range of fellowship organisations to increase access across prisons. We are also using secure laptops to facilitate access to online mutual aid groups as well as appointments with community treatment providers prior to release.
  4. We also know that women-specific services are essential for promoting sustained recovery. To support the significant proportion of women in custody who have a substance misuse need, work is ongoing in partnership with NHS England to provide a gender-specific and trauma informed approach and we are ensuring women are involved in the design and structure of mutual aid groups in prisons. Close working with children’s and family support services helps women maintain links with children during time in prison and forge strong and supportive relationships within the prison itself.

 

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

  1. We know that the availability of drugs poses a risk to the stability of prisons, exacerbates the risks of violence and self-harm and can be linked to prison debt and serious and organised crime. This can particularly affect vulnerable individuals, if they are regularly exposed to poor behaviour and violence driven by drugs.
  2. To improve safety, various measures have been introduced including removing wet shave razors in 31 adult male priority prisons, providing Body Worn Video Cameras across adult public sector prisons, and delivering training in suicide and self-harm prevention and violence reduction. We are improving our understanding of the nature, extent and repercussions of debt through a major research study.

 

Tackling the supply of drugs in prisons
What are the common routes for bringing drugs into prisons, and what recent trends have been observed in these methods?

  1. Prisons have multiple routes for drugs to enter, influenced by factors like security measures, geographical location and prisoner cohort. Intelligence analysis shows that common routes of conveyance include prisoners’ arrival into prisons, prison visits and correspondence. Conveyance via drone, items being thrown over prison walls and corrupt staff are reported to a lesser extent. .
  2. Drone sightings around prisons in England and Wales increased by over 770% between 2019 and 2023, from 122 incidents to over 1,050. As the number of incursions has increased, there has also been an observed increase in drone conveyance sophistication and the size of packages carried.      
  3. Serious and organised crime (SOC) offenders, who have access to criminal networks and resources, are often involved in drug supply in prisons. HMPPS are working with law enforcement partners such as the National Crime Agency and police to identify and confirm links between SOC offenders in prison and Organised Crime Groups (OCGs) in the community. HMPPS assesses that around 10% of the total prison population has links to SOC.   
  4. Mobile phones are a key enabler of crime in prisons, including drug supply with some prisoners accessing sophisticated wi-fi enabled devices. Security measures are used to prevent illicit mobile phones from entering prisons and prisons have a variety of equipment to mitigate their use in custody and the harm that this causes.      

 

How can the supply of drugs into prisons be better tackled to eliminate the availability of substances?

  1. Physical security is our first line of defence against contraband smuggling into prisons. Poor physical security can facilitate routes like drones and throwovers; where robust measures are in place, prisons are more resilient to these methods.
  2. In recent years, HMPPS have expanded physical countermeasures across the estate, however criminals are constantly seeking new opportunities to bypass security.    
  3. To prevent visitors (and staff) from smuggling contraband, Enhanced Gate Security (EGS) with X-ray baggage scanners, drug detection dogs and archway metal detectors is installed at 52 high-risk prison sites.
  4. The Security Investment Programme (SIP) evaluation reported that staff found that EGS successfully prevents the ingress of illicit items when used consistently. EGS is also perceived to deter people, including visitors, from bringing illicit items into establishments.    
  5. HMPPS takes a zero-tolerance approach to corruption. HMPPS’s specialist Counter Corruption Unit (CCU) helps prevent corruption through awareness packages and ensure corrupt behaviour faces serious consequences. The SIP evaluation found that staff are better equipped to identify and manage corruption.
  6. In line with Dame Carol Black’s recommendation to make the vetting process for those with lived experience less burdensome, we are delivering work to improve consistency and transparency of our processes. We are also working to ensure the level of checks increase where proportionate to the risk of the role applied for. We are developing new, user-friendly policies and guidance documents to improve our personnel security processes. This programme has already delivered a new decision-making framework for vetting officers.      
  7. While there is still progress to be made, and we acknowledge that staying ahead of sophisticated technology used by criminals is challenging, compounded by operational pressures like temporary staffing pressures, we are making effective changes through various security measures and collaborating with international counterparts and research and development teams to keep our approach up to date.

 

What examples are there of effective interventions to prevent and disrupt drug supply within prisons?

  1. Prisons have a range of effective countermeasures and initiatives to tackle the smuggling of contraband such as drugs that drive prison violence and undermine safety.
  2. To prevent drug smuggling via visitors, 98 X-ray body scanners are installed at 95 prisons covering the closed adult male estate. As of March 2024, over53,000 positive indications had been recorded, demonstrating this equipment is having a clear impact. Additionally, Enhanced Gate Security (including metal detectors and drug detection dogs) is installed at 52 high risk prison sites.
  3. To prevent drug smuggling via prison mail, 165 trace detection machines are used across all public prisons. HMPPS are actively working with industry partners to combat the emerging threat of synthetic opioids.
  4. Restricted Fly Zones were introduced in January 2024 around prisons, which make all unauthorised drone incursions a crime and support police and prison collaboration to help ensure meaningful operational responses.
  5. The Crime in Prison Referral Agreement ensures that incidents of drug supply are reported to the police and the Crime in Prisons Taskforce supports prisons to work collaboratively with law enforcement in pursuit of criminal charges.

 

How effective is collaboration between the police, National Crime Agency and HMPPS in tackling the role of organised crime gangs in bringing drugs into prisons?

  1. MOJ takes the threat of SOC incredibly seriously and we are working across government to bear down on organised criminals running their networks from within the prison estate, as well as managing their risk when released into the community.
  2. This includes collaboration with key partners including the Home Office, National Crime Agency (NCA), law enforcement agencies and HMRC. We are working with other government departments and law enforcement partners to further strengthen the whole system response, including information sharing, to SOC in prisons and probation.
  3. In recent years HMPPS has expanded its dedicated national SOC teams working jointly with law enforcement to identify and disrupt ongoing criminal activity by SOC offenders. Effective collaboration has enabled successful multi-agency operations which have resulted in criminal justice outcomes.
     

Tackling demand

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

  1. Our work to reduce demand for drugs in prison focuses on treatment, support and creating environments that are conducive to recovery. There are now over 80 prisons which have Incentivised Substance-Free Living units (ISFLs), which pair regular testing and incentives for any prisoner committing to live drug-free in prison. We are also piloting and evaluating a small number of abstinence-based Drug Recovery Wings (DRWs) to support prisoners who have a drug dependency, are ready for abstinence from illicit drugs, alcohol, and prescribed substitutes and would benefit from more intensive treatment and recovery support.
  2. We continue to build the evidence base for both models. An impact evaluation and process evaluation of ISFLs is currently underway, and we recently published the results of a qualitative study into the lived experience of ISFLs in three prisons. This highlights positives such as participating in a calm and supportive environment that enables recovery and the support of prison staff.
  3. Dame Carol Black's recent review into Drugs in Prison recommends that ISFLs be made available at every prison. We recognise the need to build on our existing ISFL offer with a stronger focus on quality and consistency across the estate and comprehensive guidance has been published to ensure all ISFLs deliver the same high standard of support.
  4. In her review, Dame Carol Black stressed the importance of shifting to a culture focussed on recovery and the key role purposeful activity plays in supporting prevention and rehabilitation. We understand that providing prisoners with a meaningful way to spend their time, such as work in prison and educational courses, helps to build important 'recovery capital', which can support people to live healthy, drug-free lifestyles. This is why the Government committed in its manifesto to improve access to purposeful activity in prisons, which we are actively exploring.

 

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

  1. A crucial component of demand reduction and recovery is reducing drug supply, so people have fewer opportunities to develop a drug problem, or to relapse. Equally important to reducing demand and promoting recovery is driving good behaviour. In prisons, we use drug testing to identify supply and to provide positive reinforcement for recovery and motivate prisoners to abstain. Any prisoner suspected of taking drugs can be required to take a mandatory drug test, ensuring we can identify prisoners with a drug problem and refer them into treatment. We also know that celebrating negative drug tests can be key to supporting a prisoner in recovery, giving them a sense of achievement, and our ISFLs encourage this.
  2. We also conduct random mandatory drug testing (rMDT) to provide performance data. However resource constraints currently limit our capacity for random mandatory drug testing across the estate, and Governors are making difficult decisions on balancing rMDT with other local priorities. As present, volumes are not sufficiently and consistently high enough to enable robust, publishable data.
  3. Our approach must constantly evolve to respond to changing drug threats, which is why we are piloting wastewater-based surveillance which could allow us to understand drug prevalence through new technology in future.

 

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

  1. In her recent review, Dame Carol Black noted that the culture in prisons can stigmatise dependent drug use. We recognise that Governors and staff play an integral role in tackling this through culture and leadership, by supporting and enabling treatment, and by feeding into commissioning.
  2. Governors play an important role in supporting the commissioning function through local partnership boards and working closely with regional NHS commissioners on the enablement and development of Substance Misuse and other healthcare services.
  3. We know that positive and supportive staff-prisoner relationships can play an important role in motivating prisoners to work towards recovery and reduce stigma around substance dependency. Staff also play a vital role in facilitating access and escorting prisoners to treatment appointments.
  4. We recognise the value of having a robust training package to ensure staff are equipped to support prisoners with a drug dependency. We have delivered workshops on emerging drug threats, and provided detailed guidance to staff.

 

Support for prisoners
To what extent is drug treatment and healthcare in prisons effective?

  1. MoJ, DHSC and health partners work closely to measure progress and, while the nature of substance dependency means recovery can be complicated, often involving multiple cycles of recovery and relapse, we are seeing positive signs.
  2. For example, the number of prisoners in treatment has increased by 14% between 2020/21 and 2023/24 to almost 50,000 adults. Nearly two-fifths (38%) of those were discharged after completing their treatment free of dependence, a 16-percentage point rise from 22% in 2015 to 2016, when reporting began.
  3. While these are encouraging signs of progress, we recognise there is more that needs to be done to ensure drug treatment and healthcare provisions continue to improve.

 

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

  1. NHS England is reviewing the Substance Misuse Service specification within prisons which drives the local commissioning arrangements. We will use the findings from this call for evidence to help inform the refresh alongside the recommendations from the Dame Carol Black review and the Chief Medical Officer Review.

 

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?

  1. We have made considerable progress since the publication of ‘From Harm to Hope’, though we know there is further to go.
  2. We have recruited 54 dedicated Drug Strategy Leads in prisons, alongside Health and Justice Partnership Coordinators in every probation region, to drive the focus on tackling drugs across the prison estate and in the community. We have also established Incentivised Substance Free Living units in over 80 prisons and are working to share good practice and ensure a consistently high-quality offer across the estate.
  3. We also know that we must ensure prison leavers can maintain progress in recovery on release. The proportion of prison leavers remaining in drug treatment post-release has substantially increased from 37.75% in April 2021 to 56.1% in December 2024, reflecting strengthened efforts to support individuals transitioning from custody to the community.
  4. Tackling drug problems in prisons is critical for improving safety, reducing reoffending, and supporting prisoner rehabilitation. While progress has been made, we recognise that there are significant challenges, and we need to build on areas of progress such as strengthening partnerships, investing in innovative approaches, and fostering greater collaboration between health and justice services to achieve long-term success.

 

 

February 2025

Page 7 of 7