Consumption of psychoactive substances in prison: Between initiation and improvement, what trajectories occur after incarceration? COSMOS study data

Abstract

BackgroundFew studies have examined the consumption trajectories of inmates after entry to prison. The aim of this study was to assess the changes in the consumption of psychoactive substance between the period before detention and during incarceration and to characterize the profiles of prisoners with similar consumption trajectories during incarceration.Methods and findingsA multicenter, cross-sectional study was performed in all of the prisons from one region of France. All prisoners incarcerated during their 3rd months, over 18 years old, and with a sufficient level of French fluency to participate in the study were recruited over a period of 12 months. A total of 800 prisoners were recruited. All prisoners were interviewed face-to-face by a trained interviewer. A majority of prisoners had used at least one psychoactive substance in the weeks prior to incarceration. During incarceration, a substantial reduction in alcohol and illicit drug consumption was observed. The initiation of consumption and an increase in consumption were primarily related to medications. Five different profiles of consumption before incarceration were identified. These profiles all had a high probability of migrating to a similar profile during detention, characterized by less severe consumption of psychoactive substances.ConclusionsBased on their consumption profile prior to incarceration, most prisoners would benefit from a specific medical evaluation as soon as possible following entry into detention. Prison could be an opportunity for reduced consumption and/or the initiation of treatment for the majority of prisoners, despite the pejorative development observed for a minority of prisoners during incarceration.

Substance Use, Substance Use Disorders, and Co-Occurring Psychiatric Disorders in Recently Incarcerated Men: A Comparison with the General Population

“…The rates of alcohol use could not be compared because different types of use were assessed in the two studies. Consequently, except for stimulants, our results are in line with previous data, even if two elements significantly differed between our study and that of Rousselet et al [28]: the sample (Rousselet et al [28] recruited both men and women) and the study design (the interview was conducted during the third month of incarceration in the work of Rousselet et al [28]).…”

“…After adjustment for sociodemographic features, past-year substance use rates remain in the same gap range. In a previous study in France by Rousselet et al [28], the reported rates of use before incarceration were 49.0% of the respondents (vs. 45.6% in our study) for cannabis, 8.9% for heroin (vs. 9.4% for illegal opioids in our study), and 16.5% for cocaine (vs. 8.6% for stimulants in our study). The rates of alcohol use could not be compared because different types of use were assessed in the two studies.…”

Factors associated with risk related to the use of psychoactive substances by men deprived of their liberty

“…Given this scenario, we identified a significant prevalence of substance abuse consumption in the lives of PDLs, mainly alcohol, tobacco, marijuana and cocaine/crack. Marijuana is the most commonly consumed illicit substance, corroborating the national and international literature 14 , 31 , with prevalence rates much higher than those observed among the general Brazilian population (marijuana 7.7%, cocaine 3.1%, crack 0.9%) 32 . Marijuana was the most commonly used illicit drug, followed by cocaine/crack and inhalants, and about a quarter had used hypnotics, hallucinogens, opioids and amphetamines or ecstasy, corroborating international studies that point to marijuana as the most commonly used illicit drug among PDLs 33 .…”

“…One study found similar results whose marijuana use was reported by 67.5% of PDLs with onset at the age of ten to 15 years 34 . Cannabis is the most commonly consumed illicit substance and can act as a “gateway” to other, heavier drugs 14 .…”

“…It is a consensus in the national and international literature that the addicts of PAS are overrepresented in the prison populations and with similar characteristics: low socioeconomic status, low education and with physical and mental health problems 12 , 14 - 16 . Because incarceration represents a constant challenge to be faced by PDLs, the public health field must be concerned with prisons as a cause of health inequities 16 .…”