International research shows that people in detention have used drugs substantially more often and are more likely to use drugs regularly. Incarcerated persons also experience drug-related problems more often than those not incarcerated. Drug use in prisons worldwide is relatively high. Yet, drug policies in prison mainly aim to combat the drug trade rather than provide care for those using drugs in prison.

In 2021, the Netherlands had nearly 30,000 people in detention across 29 penitentiary institutions. Understanding current drug use among people incarcerated in Dutch prisons is essential. In response, Correlation – European Harm Reduction Network (C-EHRN) and Trimbos Institute conducted an exploratory study in late 2022. The study, funded by the Ministry of Health, Welfare and Sport, investigated drug use in the Penitentiary Institution (PI) in Ter Apel.

Synthetic Cannabinoids (SCRAs)

The reason for the research in collaboration with Trimbos Institute is the continuous innovation in the way drugs and, in particular, synthetic cannabinoids (SCRAs) are smuggled into prison as impregnated on letter mail. There are signs of widespread synthetic cannabinoid use in Dutch prisons, which has been seen in foreign prisons for some time. One of the main reasons is that these substances are more difficult to detect than traditional drugs such as cannabis or cocaine. SCRAs impregnated on paper are odourless, and their use cannot be identified in conventional urine tests. The effects of SCRAs are similar to those of THC, making the user feel relaxed and intoxicated. However, the effects can vary considerably in strength and duration and can cause other side effects that can even be life-threatening in extreme cases.

Ter Apel

The qualitative research in the Penitentiary Institution Ter Apel is an initial exploration through a questionnaire distributed among employees and people in detention, as well as in-depth interviews held with key informants from the institution. The findings suggest high usage of SCRAs and inappropriate use of prescription pain, sleep and sedative medication, besides cannabis and alcohol use. Although drug use in the PI in Ter Apel does not seem to lead to visible significant safety or health incidents, likely, people in prison do not readily turn to the medical service for drug-related health problems, partly for fear of sanctions or stigmatization.

“The investigation results have made us realize that we have been looking at the subject of drugs for too long from a safety point of view only. We do our best to prevent drugs from being smuggled in one way or another. It is also important to look at drugs from the perspective of health, care and the professionalization of our employees.” – Laurens Huizenga, branch director PI Ter Apel.

Recommendations

In order to have a better understanding of substance use in Dutch prisons, more research is needed. Additionally, it is essential to gain better insights into the care needs of people in detention and the challenges faced by prison staff regarding drug use.
Such new research insights are necessary to implement more targeted and appropriate care and to improve access to addiction care.

The researchers advise keeping up-to-date and neutral information about drugs’ effects and health risks available to staff and people in detention. It is also desirable to have a broad and open discussion about substance use and SCRAs, particularly within the prison system.

For detailed information and more recommendations, read the research report.