Page, Geoff orcid.org/0000-0003-1612-3366, Templeton, Lorna, Grace, Sharon orcid.org/0000-0002-3499-3210 et al. (6 more authors) (2016) Conspicuous by their abstinence:the limited engagement of heroin users in English and Welsh Drug Recovery Wings. International Journal of Drug Policy. pp. 49-56. ISSN 0955-3959
Abstract
Background In recent years, an abstinence-focused, ‘recovery’ agenda has emerged in UK drug policy, largely in response to the perception that many opioid users had been ‘parked indefinitely’ on Opioid Substitution Therapy (OST). The introduction of ten pilot ‘Drug Recovery Wings’ (DRWs) in 2011 represents the application of this recovery agenda to prisons. This paper describes the DRWs’ operational models, the place of opiate dependent prisoners within them, and the challenges of delivering ‘recovery’ in prison. Methods In 2013, the implementation and operational models of all ten pilot DRWs were rapidly assessed. Up to three days were spent in each DRW, undertaking semi-structured interviews with a sample of 94 DRW staff and 102 DRW residents. Interviews were fully transcribed, and coded using grounded theory. Findings from the nine adult prisons are presented here. Results Four types of DRW were identified, distinguished by their size and selection criteria. Strikingly, no mid- or large-sized units regularly supported OST recipients through detoxification. Type A were large units whose residents were mostly on OST with long criminal records and few social or personal resources. Detoxification was rare, and medication reduction slow. Type B's mid-sized DRW was developed as a psychosocial support service for OST clients seeking detoxification. However, staff struggled to find such prisoners, and detoxification again proved rare. Type C DRWs focused on abstinence from all drugs, including OST. Though OST clients were not intentionally excluded, very few applied to these wings. Only Type D DRWs, offering intensive treatment on very small wings, regularly recruited OST recipients into abstinence-focused interventions. Conclusion Prison units wishing to support OST recipients in making greater progress towards abstinence may need to be small, intensive and take a stepped approach based on preparatory motivational work and extensive preparation for release. However, concerns about post-release deaths will remain.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 Elsevier B.V.This is an author produced version of a paper accepted for publication in International Journal of Drug Policy. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Heroin Dependence,PRISONERS,drug recovery,Engagement |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Social Sciences (York) > Social Policy and Social Work (York) |
Depositing User: | Pure (York) |
Date Deposited: | 28 Jan 2016 15:26 |
Last Modified: | 16 Oct 2024 12:45 |
Published Version: | https://doi.org/10.1016/j.drugpo.2015.12.006 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1016/j.drugpo.2015.12.006 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:93459 |