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Substance misuse as a marker of vulnerability among male prisoners on remand

  • Deborah Brooke (a1), Caecilia Taylor (a1), John Gunn (a1) and Anthony Maden (a1)



More treatment for substance misuse should be provided within prisons.


To examine differences between prisoners on remand with substance misuse problems and other prisoners on remand.


Random selection and interview of unconvicted male prisoners (n=750, a 9.4% sample), plus examination of the prison medical record.


Of the sample of 750, 253 subjects (33.7%) reported either drug- or alcohol-related health problems or dependency. Compared with other prisoners on remand, they reported more childhood adversity, conduct disorder, self-harm, past psychiatric treatment and current mood disorder, and had fewer qualifications, were more likely to be unemployed and have more housing difficulties.


One-third of unconvicted men in prison report substance-related problems, and these are a marker for vulnerability within a disadvantaged population. Health care providers should involve this group in treatment and rehabilitation, both inside prison and following release.


Corresponding author

Deborah Brooke, The Bracton Centre, Bexley Hospital, Old Bexley Lane, Bexley, Kent DA5 2BW, UK. Tel: 01322 294300; fax: 01322 293595


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Declaration of interest

The study was funded by the Home Office Research and Planning Unit, for the Directorate of Health Care. The views expressed are the authors' own.



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Substance misuse as a marker of vulnerability among male prisoners on remand

  • Deborah Brooke (a1), Caecilia Taylor (a1), John Gunn (a1) and Anthony Maden (a1)
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Substance abuse in Sri Lanka � A growing problem.

Ravi Jayawardana, Medical Officer
05 May 2005

Sir: It is with interest I read the article “Substance misuse as a marker of vulnerability among male prisoners on remand “providing information and stimulating debate on substance misuse (1).Rapid urbanization taking place in Sri Lanka has lead to many social and psychological changes which were previously not encountered in the island.Until the last few decades, if not for centuries, Sri Lankan community wasimmune to most of the health related issues due to substance misuse. This is largely attributable to the lack of more addictive substances like heroin and other opiates and most importantly, the protective influences exerted by the traditional Sri Lankan family atmosphere. Except for the consumption of locally brewed alcohol, tobacco and to a lesser extent cannabis, substance misuse was not a major health related issue in Sri Lanka. Rapid urbanization occurring not only in Sri Lanka, but in many other developing nations is causing abrupt changes in the life style and the family structure. Interestingly these changes correspond with the changes in habits of substance misuse as well. The most significant issue of all is the introduction of heroin to the island in the early 1980. Heroin addiction is currently becoming a serioushealth threat particularly to the younger age group. In addition the consumption of liquor has increased considerably and it affects both younger and older age groups.These changes coupled with unemployment have lead to a diverse array of social problems including the increased incidence of crimes and fraudulentactivities in the island. As remedial action, the government has tightened the existing legislature and imposed new laws in order to cub the growing issue of substance misuse, particularly heroin misuse. Consequently the number of prison admissions due to heroin and other substance misuse has steadily increasedultimately overburdening the prisons and associated rehabilitation services. Currently there is a large group of people who were imprisoned several times, each time the offence is related to substance misuse demonstrating a serious fault in the rehabilitation process which is partly due to the overburdening of prisons itself (2). Though many suggestions were made to minimize the impact of substance misuse on the community, the progress is further hampered by the lack of resources in the government. If the problem continues into the future it will undoubtedly create a health care crisis in Sri Lanka.

References.(1). Brooke, D., Taylor, C., Gunn, J., Maden, A. (2000) Substance misuse as a marker of vulnerability among male prisoners on remand. British Journal of Psychiatry, 177: 248-251.(2). Peris, M.U.P.K., Jayawardana, M.A.R., Fernando, W.D.D. Substance abuse among the inmates of Mahara Prison. Sri Lanka College of Psychiatrists Annual Academic Sessions 2005.
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