HIV and incarceration: prisons and detention

The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release

Psychosocial Risk Factors in Disordered Gambling: A Descriptive Systematic Overview of Vulnerable Populations

Background: Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored. Methods: To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups. Results: Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group. Conclusion: Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual’s relationship with gambling

Provision of harm reduction and drug treatment services in custodial settings – Findings from the European ACCESS study

<p><i>Aims</i>: The aim of the study was to survey the availability, coverage and quality of harm reduction and drug treatment services delivered to drug users in prisons across Europe. <i>Methods</i>: A survey was conducted between 2012 and 2013 among the 29 European countries. An electronic semistructured questionnaire was sent to the national institutions responsible for prison services, and 27 countries responded. In addition, good practice interventions for drug offenders have been collated by 15 national experts covering 15 European countries. The interventions were described and assessed as to their quality through using European monitoring centre for drugs and drug addiction (EMCDDA) standard tools for reporting and quality assessment. <i>Findings</i>: Drug treatment including detoxification and opioid substitution treatment (OST) is available in prisons of most European countries. However, OST is unavailable in five countries. Almost all countries provide prison-based harm reduction measures to prevent and treat infectious diseases among prisoners. Especially, testing and treatment for HIV and tuberculosis are provided, while other measures, such as the distribution of condoms or bleach, and especially needle and syringe programmes are still rare. <i>Conclusions</i>: Access to and coverage of OST in prisons is higher in countries with a long history of OST provision, while in countries that introduced OST more recently the scale of OST is usually lower. Access to hepatitis C treatment is often limited in prisons due to the lack of drug abstinence or a health insurance.</p

Drug consumption facilities: an update since 2000.

The topic of drug consumption facilities or rooms (DCRs) was reviewed by Dolan, Kimber and others in Harm Reduction Digest 10, published in the September 2000 issue of DAR. As one of the first English language papers on the topic this paper has been cited extensively. Now, 3 years on, these authors and have brought together an international team of experts to revisit the topic. In this update they: (i) highlight where DCRs are operating or under consideration, (ii) review briefly new literature and (iii) discuss future directions. This Digest is a 'must read' for policy makers, advocates and practitioners in the drug field

Drug policy and harm reduction SANCO/2006/C4/02 Final Report on Prevention, Treatment, and Harm Reduction Services in Prison, on Reintegration Services on Release from Prison and Methods to Monitor/Analyse Drug use among Prisoners

Addiction Research (CIAR) Neither the European Commission nor any person acting on its behalf is responsible for the use which might be made of the information contained herein

Different phases of ATS use call for different interventions: a large qualitative study in Europe.

BACKGROUND: Amphetamine-type stimulants (ATS) are globally widely used. Scientific literature generally defines four phases of substance use (initiation, continuation, increase and decrease); however, there is limited understanding of what influences these different phases of ATS use. The ATTUNE study investigated which factors shape individual phases of use, or ATS use patterns. In this article, we report on these phases into and out of ATS use, and propose a set of recommendations for prevention, harm reduction and treatment of the different phases of ATS use. METHODS: Qualitative, semi-structured interviews (n = 237) were conducted in five different European countries with participants who had used ATS, varying from a few times in a lifetime to daily. RESULTS: Amphetamine and MDMA were the most commonly used ATS. Yet, types of ATS used differed between the countries. We found that people who use ATS have various motives for and dynamic patterns of ATS use with alternating phases of increase, continuation, decrease and sometimes dependence. Cessation was pursued in different ways and for diverse reasons, such as mental health problems and maturing out. Availability seemed not an issue, regardless of the type of ATS, phase or country. CONCLUSIONS: These findings demonstrate that tailor-made interventions are needed for the diverse types of people who use ATS and different phases or patterns of ATS use, to reduce possible harms of use. We recommended a set of interventions for the different ATS phases. These include drug checking services, peer-led information, self-management of ATS use, mental health support to help people cope with stressful life events and prevent uncontrolled use, and follow-up support after treatment