In this paper, we focus upon the epidemiology of ‘drug use’. Drug use is broadly defined to include one-off consumption. Most often studies focusing on prisoners’ drug use are based on a medical model, thereby measuring the prevalence of specific diagnoses (Skardhamar, 2003). In this paper we want to complete this approach for two reasons: first, systematic reviews of literature on the topic of
substance ‘disorders’ in prison have already been conducted (Fazel, Bains & Doll, 2006; Oliemeulen, Vuijk, Rovers & Van den Eijnden, 2007). Second, starting from a criminological point of view, we relocate the focus by conducting a review of epidemiological literature on drug use (not on drug abuse, drug dependence or other substance ‘disorders’1) in order to obtain a more global picture of this phenomenon. We focus upon the use of illegal drugs, alcohol and the illegal use of medication
before, during and after detention. The second limitation of this paper’s scope is a geographical one. The focus is placed upon ‘European (ex-) prisoners’, more specifically the prisoners in the Council of Europe-prisons because the Council of Europe is a very important international player in the prison-arena (e.g. the European Prison Rules) (Elger, Maklu 227 1 There is no agreement in international literature about the terminology used. More recent attempts to achieve conformity in literature are the DSM-IV and ICD-10 criteria. 2008). The search for literature was also limited in time; only publications published during ‘the last ten years’ were included.2 A review of published research was undertaken. This was done using a variety of electronic library databases. Databases consulted were Web of Science, PubMed Central, Trimbos-instituut, WODC, Drugscope, EMCDDA and Sage Publications. The websites of the EMCDDA, PubMed and Web of Science returned the most results. An extensive search of Internet sources was also undertaken. Websites of various government and non-government bodies were consulted. The key search terms used were: prison(s), prisoner(s), inmate(s), detention, incarceration, detainee(s), release, re-entry. These words were combined with: ((il) legal) drug(s) (use), ((il) licit) drugs), alcohol, (psychoactive) substance(s) (use), narcotic(s), IDU. These terms were also combined with specific regions (e.g. Europe or Eastern-Europe) and countries (e.g. Bulgaria or Spain). We were interested in epidemiological studies, based on scientific methods and data. In our search for literature we also found interesting, but non-scientific, publications on the epidemiology of drug use among (ex-) prisoners. These results were based, for example, upon estimates of prison or drug experts, not on scientific data: these publications were, therefore, excluded (M. MacDonald,
2001). For the same reason, publications were also excluded when we had no information about the methodology used (Dolan, Kite, Black, Aceijas & Stimson, 2007; Drug Control Department, 2006; National Anti-Drug Agency, 2006; Stubblefield & Wohl, 2000). In this paper, four main questions are addressed in order to reveal what is already known about the epidemiology of drug use patterns among European prisoners before, during and after detention. Firstly, what is measured in Europe and what isn’t? Secondly, how do researchers measure drug use among prisoners? Thirdly, what are the most important findings? Fourthly, what information is still lacking on drug use patterns among European prisoners.