Introduction
Drugs may be categorised as both good and bad depending on their usage acceptability and the quantum taken. If taken for the purpose of medication under expert guidance it will not have any side effects .However, when illegal drugs are used or when alcohol intake is uncontrollable, ( or both) then the usage of such matter comes under the category of abuse. This paper seeks to explore few aspects of substance abuse and misuse. It will in particular address substance use disorder, usage of drugs in prison and what are the precautions being taken in such an environment.
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What is substance use disorder?
(Health, 2010)Increased dependence on drugs and alcohol and an addiction towards it is termed as Substance use disorder .They are usually complex problems. Individuals afflicted with such disorders were at one point of time thought to be mentally deranged or people with a moral weakness. But medical researchers and scientists are of a different view. These people consider such a condition or prolonged dependence of alcohol or drugs to be a long term illness similar to that of asthma, hypertension, diabetes and many more. Usually people consuming alcohol drink very little and people who take drugs can abstain from doing so very easily. However, the situation is not the same with everyone and such individuals develop substance use disorder.
Substance use disorder can affect anyone (Children, adults, the poor and the rich). It is an illness. The cause of it is not clearly known, however to a certain extent it can be said that it is a result of one’s genes. The environment in which a person lives; certain psychological traits and varying stress levels can also be attributed to such conditions. According to research continual usage of drugs changes the brain in very fundamental ways and as a result has a long lasting and serious impact. The degree of change varies from person to person but when the change happens it radically changes the person. An individual who uses drugs from a very early stage is at a greater risk of being seriously afflicted than a person who starts at a later age. The changes are so drastic that even after a person stops using alcohol they have a long lasting impact on the person
Why do some people misuse substance?
Substance misuse has been termed as an issue on a large scale that not only has an impact on the lifestyle of an individual but on his entire environment.
Substance abuse may be attributed to bad child hood experiences. Example: Individuals may have been neglected as a child or may have been subjected to severe abuse. Such individuals resort to substance misuse so as to minimise their extent of negative emotions or stress related situations. Additionally, individuals may also resort to such a mechanism so as to hide their guilt or any such emotions that causes pain to them and these mechanisms prove to be a source of relief during such times. Only if the issues mentioned above are properly addressed, it is then that they begin to adapt or acquire new approaches to handle such situations .Otherwise the patient will continue to use substances that relieve them of emotional trauma. Such individuals remain mentally and physically totally un available to their surroundings and families.
For adults with children and those who are subject to substance abuse; it becomes very difficult for them to handle their children For instances, buying and seeing that there are enough funds to by the next lit take a greater priority than taking care of children. Also when an individual is subjected to such conditions, they will not b in a position to respond effectively children. They would usually be irritable, paranoid or totally incapable of taking care of their children
Drug Users and drug use in Prisons
(Anon, 2010) Clubbers partygoers take up to drugs to enliven their spirits .Some take to drugs to so that they will be able to dance and have the energy and enthusiasm to do so even after a prolonged time. There is the other category who resort to drugs (legal) to get relived from some pain like pain killers or some prescribed drug to get cured of some ailment .There is yet another category which takes to drugs and this has those people who have a very low self esteem or are socially very shy. Such people take drugs so that it gives them a good amount of self confidence
A few people enjoy taking drugs; this includes some amount of alcohol or a cigarette smoke. They consider this activity very harmless because they are very much n control of the situation. Another factor that needs to be considered is pressure .Foe example of an individual is exposed to an atmosphere where taking drugs is rampant and is a part of the culture one is sure to be tempted
The imprisonment rates of some countries in eastern Europe are among the highest in the world. For example, the imprisonment rate in the Russian Federation in 2003 was 600 per 100 000 population, second only to rates in the United States of America. Typical rates in western European countries are 50-100 per 100 000 population.
(“World Health Organization, 2005) Many prisoners in Europe have a recorded history of drug use and many people going to prison have a very severe drug problem. The United kingdom also contributes to this list.
(McDevitt, 2007)A Heroin substitute is being rampantly used in the Prisons of Britain .This is what a new research conducted says .About 70% and odd inmates of the prison regularly consume Subtex. The latest survey conducted between April and July reveals that this substance is used in about 40 prisons across Britain. The data also shows that when compared to young adults, it is the older one who injects more drugs and also that women are likely to outnumber men in this case.
The EMCDDA in 2004 reported that the number of people using illicit drugs differ across the European union. The data has been made available for 11 out of 25 countries including Norway .This data ranges from 22% to 86%. The most popular drug is cannabis.
The life time prevalent rates for
Cannabis 11 – 86%
Cocaine 5-57%
Heroin 5-66%.
.
Prison as a Risk Environment
(World Health Organization, 2005)The presence of illicit drugs and the associated harm from their problematic use has changed considerably the reality of prisons throughout Europe and the rest of the world. In the past two decades or so, the linked resurgence of communicable diseases such as tuberculosis and sexually transmitted diseases and the arrival of the new life-threatening epidemic of HIV/AIDS as well as the increasing attention being paid to the prevalence of hepatitis C has led all countries to seek the best ways of reducing their harmful health, economic and social effects.
Prisons are extremely vulnerable to HIV transmission due to overcrowding, lack of proper nutrition and virtually no access to health care. The prisons in UK are no where far away from this list. To add to this list are
Unsafe drug injecting mechanisms.
Unprotected sex
Tattooing
Most of the people inhabiting the prisons come from very poor backgrounds and they come with an already heightened condition of HIV. Also people affected with HIV who occupy a particular cell have access to the injecting room. Apart from this they also get access to counters where unprotected sex is rampant. The rates at which syringes are shared are higher in prisons than amongst people injecting drugs outside. The situation is worsened by alarming rates of TB (which is usually resistant to many drugs) hepatitis Band C including sexually transmitted diseases. TB and Syphilis are quite rampant as well.
10% of HIV cases are due to unsafe injecting mechanisms. Eastern Europe and Asia record up to 90% of HIV due to injecting drugs. When compared to the general population the HIV infection rate is higher at detention centres and prisons are higher.
UK accounts for 32%
The other categorisation of drug users with respect to tuberculosis in Europe is that
Western Europe – 30%
Central Europe – 25%
Eastern Europe 50%
Provision of Drug related service in Prison
(Berto, 2002)The use of drugs inside the prison premises reflects the inability of the prison police department to put a check to these kinds of illegal acts. The Home Secretary, Michael Howard, stated that there is certain amount of fear among the public regarding the accessibility of drugs inside the prison and as a counteract to this, the prison police have decided to act tough.
In the recent statement given to the media by the director general of the Prison Service, Derek Lewis, that a counter act with the name “war on drugs” should be waged in order to prevent the usage of drugs inside the prison. This is to be dealt seriously as this may give way for supply for arms to the prisoners. The concerned authorities need to learn from the past experience and try to educate the people responsible for the supply of drugs. It is better not to use language which provokes challenging thoughts.
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Prison gives the best chance to help prisoners abstain from using drugs as some of them may have addicted to drugs before. Prison offers an opportunity to rectify their mistake which they have done as part of their offence. The aim of the prison service should be to identify drug adductors and counsel them about the ill effects of drug usage. Security needs to be beefed up to put an end to the supply of drugs in to the prisons. Security must be made efficient. Awareness camps and educational programmes must be conducted so that they change into social beings and mingle with people after their release. This reduces the number of drug related crimes in future.
(Flynn)The World Health Organisation Regional Office for Europe established the WHO Health in Prisons Project in response to the alarming rate of HIV transmission.
Various countries have introduced prevention programmes in prisons such as:
Awareness about HIV/AIDS
Testing and counselling at HIV awareness camps.
Distribution of condoms to reduce unprotected sex.
Bleach or other disinfectants
Knowledge of using needles and syringes
The system in England and Wales goes like this:
Under the mandatory drug testing programme (MDT) about 10% of the people in the prisons are tested randomly every month.
The services are provided by an external agency called CARAT.
These services include
Timely detection of drug misusers
Provide continual support and advice to the prison inmates
Closely work with external agencies as well as the prison authorities to provide timely help and the right intervention so as to reduce further spread of the diseases
link the diverse s departments including the agencies which deal with prisoners so as to offer smooth flowing service between treatment in jail and the treatment available after release
Evidence on effectiveness of drug treatment and harm reduction in prison
The prisons of England provide certain amount of services that that help in the reduction of diseases being spread.
One of the principle objectives of the Department of Health Care in the UK, which was founded in the year 1993, is to lay more emphasis on improving the health of the inmates. This was a reflection of national health care trend. The Health Advisory Committee for the service of prisons liked the idea and wanted to take it forward (Rhodes, 1994) and as a result implements the following
Creates awareness about the results of harmful usage of drugs as part of statement released by the public health and human rights.
Accepts the new incumbents inside the prison and understand their requirements and give knowledge about the after effects.
Provides infrastructure in order to educate on the concept and consequences of HIV and other communicable diseases.
Gives medical support for individuals severely addicted to drugs at the clinics in prisons.
Updates every inmate regarding their health status which is a must for individuals addicted to drugs
Acts responsibly and tries to provide additional information for the benefit of its inmates
Introduces special clinics for drug needy and explaining the therapies which help them.
Challenges of a Prison officer
(service)The prison officers work with the captives closely; they manage and handle the activities of the prisoners. Apart from this these individuals are also expected to promote good social behaviour and must ensure that all the rules and regulations of the prisons are adhered to. This role require a lot of motivation and self encouragement because they work in a very dull and tiring atmosphere and their job requires them to constantly keep a check and eye the prisoners vigilantly. This proves to be very challenging The officers are required to uphold and abide by the code of conduct of the prisons. and work ethically and in an unbiased manner. Quality and competency are the foremost requisites that should not be compromised at any cost.
Conclusion
Substance abuse is a very serious offense as it mars the life of an individual completely. It has a very grave impact on the physical, mental and emotional state of an individual. If such a practice is also rampant even in prisons then it becomes even more difficult to control. Governments and health agencies have been taking measures to control these practices and offer a better standard of living for the people. It is all the more better if access to such sources can be cut off so that the problem in nipped in the bud.
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