Currently, three main types of drug testing are carried out in prisons in England and Wales:
a) Clinical testing is undertaken by healthcare professionals and is provided to prisoners entering or already in treatment. It looks to discover what drugs a patient has taken recently to inform a diagnosis of dependence and consequential clinical management. The results of tests are considered as ‘clinical in confidence’ and are not shared with HMPPS staff.
b) Voluntary/therapeutic drug testing (VDT) is, as its name suggests, undertaken by consent. The results of the tests are used to validate a prisoner’s success in compliance with treatment and in becoming drug free. Results are not used for evidential or punitive action.
c) Mandatory drug testing (MDT) is undertaken on a compulsory basis. There are five types of MDT testing: "on reception"; "on suspicion" testing where there is reason to believe someone has used drugs; "frequent" testing to ensure compliance; "risk assessment" testing used for those going out on release on temporary licence or using machinery or undertaking a driving job; and "random" testing which takes place monthly in all prisons on a random selection of 5 to 10% of the population. This last type of MDT is used to measure the level of drug misuse in prisons. Independent research carried out by the Office for National Statistics (published in 2005) concluded that MDT broadly meets its objectives and that random MDT provides a reliable and statistically valid way of measuring patterns and trends of drug misuse in prisons at national and regional level.
4. In addition, periodic prevalence testing is an established process undertaken in prisons in England and Wales to help identify any new substances that are being found routinely in either mandatory or voluntary drug testing samples. Prevalence studies use anonymised samples and cover a much wider range of drugs than are tested for under the drug testing framework above.
5. Between 2012/13 and 2016/17, the rate of positive random tests for conventional controlled drugs in prisons increased by a third. In 2012/13, 7.0% of random mandatory drugs tests were positive compared to 9.3% in 2016/17. Drug use in prisons occurs across the estate, but is especially prevalent in male local prisons, and in male Category B and C training prisons.
6. Misuse of illicit substances causes significant harm not only to those taking, but to other prisoners and to those working in prisons. Many prisoners coming into prison (around 55%) have very high levels of substance misuse problems, characterised by abuse of traditional drugs and prescribed medications, and high levels of injecting behaviour. Misuse of these substances can have a significant impact on the physical and mental wellbeing of individuals taking them, both in the short and long-term. They also fundamentally undermine an individual’s ability to engage in rehabilitation.
7. In addition to the health problems caused by substance misuse use, debt resulting from the supply, distribution and use of such substances within the illicit economy is a major cause of violence, bullying and self-harm.
8. The drugs market in prisons also has an adverse effect on the wider community. Family and friends of prisoners can be drawn into the illicit trade, through extortion and coercion. Organised crime gangs generate significant profits from supplying drugs into prisons (some drugs in prisons can sell at significantly more than street value) and use them to fund criminal activity in the community.
In recent years, prisons have faced additional challenges from changes in the type of illicit substances available within the illicit economy. The emergence of psychoactive substances was described as a "game changer" by the former Prisons and Probation Ombudsman.
There were 851 recorded seizures of psychoactive substances in prison during October and November 2015.
The PPO found that in 39 deaths in prison between June 2013 and June 2015, the prisoners were known, or strongly suspected, to have been using psychoactive substances before their deaths.
In July 2016, HM Chief Inspector of Prisons described the ‘unpredictable and extreme… dramatic and destabilising’ effects of psychoactive substances, which in his view contributed in ‘large part’ to the violence in prisons.
In his 2017 annual report, the Chief Inspector repeated concerns about new psychoactive substances (NPS):
In particular, NPS remained a significant issue in most adult male prisons. As identified in our last two annual reports, NPS continued to be linked to violence, debt, organised crime and medical emergencies. 5
10. In addition to problems posed by psychoactive substances, there is increasing evidence of the misuse of prescription only and pharmacy medicines in prison, either on their own or taken with other substances for additive effect. A study of drug use in the north-west of England found widespread abuse of prescription medicines. 6 There is also evidence that some prisoners engage in poly-drug misuse: for example, combining traditional drugs, prescribed medications and psychoactive substances. 7 This results in a particularly toxic mix and can cause significant harm to an individual’s health.
11. Currently, the prison drug testing framework does not include provision for mandatory testing for medicines.
2 House of Lords written question HL4385
3 Prisons and Probation Ombudsman (2015) Learning lessons bulletin: New psychoactive substances, London: PPO
4 Her Majesty’s Chief Inspector of Prisons, Annual Report, 2016: https://www.justiceinspectorates.gov.uk/hmiprisons/media/press-releases/2016/07/hm-inspectorate-of-prisons-annual-report-201516-prisons-unacceptably-violent-and-dangerous-warns-chief-inspector/