Approved Premise (APs), home to people
released from prison or on bail or court orders, need more
effective drug testing practices and better staff guidance to
identify and address the risks associated with substance
misuse, and support individuals, according to a report by
the Prisons and Probation Ombudsman (PPO).
Overdoses of opiate and other drugs,
including alcohol, by people released from prison remain a
significant risk, the PPO ‘Learning Lessons’ bulletin found.
People are at a higher risk of overdose if they slip back into
drug and alcohol use after periods of abstinence or
detoxification.
The bulletin
- Approved Premises – substance
misuse - based on findings from
deaths in APs investigated by the PPO also raised significant
concerns about New Psychoactive Substances (NPS). These range
from stimulants to hallucinogens and are commonly seen
in prisons and the community as synthetic cannabinoids, known by
names such as Spice and Mamba.
Elizabeth Moody, the acting Ombudsman,
said: “The rise of New Psychoactive Substance use in the prison
estate is well documented and is widely recognised, in the words
of the previous Ombudsman, as a “game-changer”. However, it is
clear from our investigations that the implications of NPS for
the AP estate have not yet been fully understood or addressed by
the National Probation Service (which is responsible for
APs).”
The PPO examined 29 of their investigations
into AP deaths that were drug-related, or where there was a
history of substance misuse. The bulletin expressed concern that
testing for NPS in APs “appears to lag behind that in
prisons and does not draw on the experience of
prisons”. One case study in the bulletin discloses
that AP staff were unable to test a man despite their
concern he had taken NPS.
The PPO found some good practice in
the management and care for those who misuse drugs and alcohol.
However, Elizabeth Moody added, “we also see cases with too
little focus on the risk of relapse and overdose.”
Some of the PPO investigations identified
deficiencies in information sharing and in welfare checks. The
bulletin made a number of recommendations relating to:
-
· Ensuring
a good flow of information between stakeholders, which is
critical, particularly for managing substance misuse where
there is a clear requirement for effective multi-disciplinary
working. PPO investigations found this did not always
happen.
-
· Checks
on the welfare of AP residents - another important way to
ensure the risks associated with substance abuse are well
managed. PPO investigations found checks were not always
carried out effectively.
-
· An
overarching need for the National Probation Service to improve
the AP manual to give staff better guidance on NPS use,
information sharing and making welfare checks.
Elizabeth Moody said:
“We know offenders can be at heightened
risk of death following their release into the community. I hope
this bulletin will help AP staff apply the learning from our
investigations to improve the ways they identify, monitor and
address the risk factors associated with substance
misuse.”
- ENDS -
NOTES TO EDITORS
1. The bullet is
available here - https://www.ppo.gov.uk/?p=10336
2. There are 101 APs
in England and Wales, providing accommodation for
2,267 residents. APs are the responsibility of the National
Probation Service. Some are managed directly by the National
Probation Service and some are managed by contractors.
3. APs are
staffed 24 hours a day and provide an enhanced level of
residential supervision in the community, as well as a supportive
and structured environment to reduce the likelihood of further
offending and manage risk.
4. There is a
high risk of overdose in the first month after release from
prison and the first few days after release are the peak period –
possibly due to changes in individual tolerance for opiates,
which can decrease in a matter of days after a period of
abstinence, and/ or a lack of understanding of the strength of
the illicit substances available in the community. The risk of
overdose is particularly acute when the resident has undertaken a
detoxification programme in prison. The risk of death for newly
released prisoners is between 40 and 70 times higher than the
general population.
5. The PPO
investigates deaths in APs as well as other places of detention,
including prisons.
6. The PPO
investigated 46 deaths in APs from September 2012 to August 2017.
There were 29 cases where the resident’s death was drug-related
or where they had an identified history of substance
misuse.
