“Just using old works”: injecting risk behaviour in prison

Abstract

A minority of injecting drug users engage in high risk injecting behaviours when in prison. In the United Kingdom between a quarter and a third of injectors who enter prison inject when in prison, and of these about three-quarters share needles and syringes. In the present study, 44 drug injectors who had been released from prison for no longer than 6 months were recruited and interviewed in three geographical areas in England. Interviewees were asked to recount their experiences of drug use during their most recent period of imprisonment. The majority of interviewees were male (38/44), had a mean age of 28 years, with a mean age of 16 years at first drug use, were primarily opiate users (39) and had multiple imprisonments. All respondents reported drug use when imprisoned and drug injecting was reported by 16 interviewees. Most injected at irregular intervals and at a reduced level, compared with injecting when in the community. Nine reported using needles and syringes that others had previously used. When considering other injecting equipment, more sharing occurred than was actually reported. Much re-use of equipment was viewed simply as "using old works". The sharing of "cookers" and "filters", and drug sharing by "backloading" and "frontloading" were common. The concept of "sharing" tended to be understood by respondents as related to the use of tools of injection (needles and syringes rather than other equipment); the use of tools in the act of injection (rather than for mixing drugs); proximity (multiple use of needles and syringes in the presence of others); temporality (shorter time elapse between consecutive use of needles and syringes previously used by another) and source (hired rather than borrowed or bought). We conclude that syringe sharing is an integral part of drug use and drug injecting in prison. Many of those interviewed displayed a restricted understanding of what denotes syringe sharing. Our data reinforce the need for interventions and initiatives to be developed within prisons to deal with the considerable risk posed by continued injecting drug use.

Drug Injectors and the Cleaning of Needles and Syringes

“…To facilitate smuggling, syringes can also be 'cut down' and 'made up' with substitute materials when needle and syringe sets were incomplete. Two examples of these types of needles and syringes are illustrated in figures 1 and 2, which have also been found in other work [67][68][69][70][71]. In the present study Terry, for example, describes the types of needles and syringes that are used in prison: The thing they had was a weapon, it weren't a works, it was a proper weapon.…”

“…Chemicals include bleach, toilet disinfectant, washing-up liquid, soap, salt, and colour agents. As noted in other work both outside [72] and inside [68,71] prison, the unavailability of clean-ing materials is one obvious impediment to preventing its use. In prison the more effective cleaning materials, notably bleach, were not always readily available.…”

“…However, supplies of fresh hot and cold water may be more limited inside prison [68,71]. Outside prison drug injectors use water and a number of chemicals and detergents to clean needles and syringes.…”

Injecting drug use in prison: prevalence and implications for needle exchange policy

“…Whilst reasons for men reporting this intention were not explored in the current study, they may concur with qualitative research exploring injecting practices in English prisons (Hughes, 2004;Tompkins and Wright, 2012;Turnbull et al, 1996). These include the overpowering desire to overcome boredom and feelings of intense drug withdrawal by quickly feeling the immediate effects of the injected drug (Hughes, 2004;Tompkins and Wright, 2012;Turnbull et al, 1996). In a later study, the daring element of injecting encouraged men to do so in prison, purposefully rebelling against the prison rules (Tompkins and Wright, 2012).…”

Drug Injectors and Prison Mandatory Drug Testing

“…Whilst Farrell et al (1998) note that there was no 'substantial' switch from cannabis to heroin use, small numbers of people have been identified as switching from cannabis to opiates albeit temporarily (Edgar and O'Donnell 1998). Some people may start to inject drugs in prison for the first time , and a lack of sterile injecting equipment in prison and injecting risk behaviour (Turnbull et al 1996) can lead to the transmission of infection (Taylor et al 1995). These are neglected issues in current prison policy.…”