Post on 10-Mar-2018
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What works for integration after prison releaseFindings from a European study
CARE‐
Quality and continuity of care for
drug users in prisons
Heike Zurhold, Germany
zurhold@uke.de
Study design implemeted by Gergely Fliegauf (HU), Andrej Kastelic, Nusa
Segrec (SI), Diana Castro (PT), Gerasimos Papanastasatos (GRE), Heike
Zurhold (DE)
Background
Research indicates that integration after prison release is not associated with the length of time living in community
Ongoing care and adequate preparationion for release has shown to facilitate community transition and prevent
relapses
Aim of the study
To evaluate key interventions provided in prison and after release and their impact on integration
To examine the living conditions after release and compare the prisoners’
stage of integration
Inclusion criteria
Adults (18 years old), have or had drugs problems related to opiates, cocaine or amphetamines
Having been released from prison since the maximum period of 10 weeks
Method
Structured questionnaire for data comparison – self‐administered or face‐to‐face
Inclusion of 50 participants in each country –
basically in big cities, except Slovenia
Data collection
Over a period of one year (11.11.2013 to 04.11.2014)
Access to participants through a variety of drug treatment programmes, social services for offenders or marginalised
individuals, probation services
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The participants3
Greece Germany Hungary Portugal Slovenia Total Statistics
Number of participants 35 27 52 50 28 192
Gender (male) 28 (80%) 20 (74%) 32 (62%) 44 (88%) 24 (86%) 148 (77%) p<0.05
Age (mean) 37.7 39.1 34.5 40.0 33.6 37.1 p<0.01
Days since prison release
(mean)62.0 40.3 33.2 55.8 28.7 44.8 p<0.001
Lengths of last prison stay
in months (mean)12.7 11.3 19.2 37.4 22.4 22.3 p<0.001
Frequency of
imprisonments (mean)2.9 6.5 3.3 1.8 2.4 3.2 p<0.001
Overall duration of
imprisonments in months
(mean)40.9 79.8 47.6 72.8 44.9 57.7 p<0.05
The participants in the countries/cities differ significantly in their age, the period of release and
their prison burden
zurhold@uke.de
Utilisation of drug treatment and harm reduction (n=192)
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Drug treatment = detoxification, OST, TC, individual drug counselling and outpatient treatmentHarm reduction = psychosocial support, overdose prevention, relapse prevention, health education, NSP
Drug treatment p<0.001 Harm Reduction p<0.05
zurhold@uke.de
Support for community transition
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Greece Germany Hungary Portugal Slovenia Total Statistics
Was prepared for release
(n=189)36% 30% 14% 18% 54% 27% p<0.01
Released on probation
(n=188)69% 31% 37% 30% 39% 40% p<0.01
Utilised probation
service after release
(n=75)27% 100% 32% 47% 18% 39% p<0.01
Most drug users have not been prepared for release – despite treatment participationMost of those being released on probation (n=75) did not use a probation service
zurhold@uke.de
Use of illicit substances since release (n=168)
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Heroin, cocaine/crack, amphetamines, crystal, non‐prescribed substances ‐
cannabis was not includedResults for use at the 1. day of release are significant (p=0.001)
zurhold@uke.de
Offenses since release (n=192)7
The country differences in offending are statistically significant (p<0.05)
zurhold@uke.de
Main source of income after release (n=172)
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‘Legal only’
covers salary from employment, unemployment benefit and welfare
benefitThe country differences are statistically significant (p<0.001)
zurhold@uke.de
Three groups according to their stage of integration
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Integration criteria: „substance use“
and „offenses“
Group 1 – integrated
No substance use or only use of legal substances (prescribed benzodiazepines,
OST and/or alcohol) and no offenses since release (n=47; 25%)
Group 3 – non integrated
Use of illicit substances and offending since prison release. Offending does not
include drug possession only but all other types of offenses such as drug
selling, thefts (n=60; 31%)
Group 2 –
undetermined
All those drug using offenders who did not meet the criteria of group 1 or 3
(n=85; 44%)
zurhold@uke.de
Groups according to the countries (n=192)
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Group comparison: Drug treatment utilisation
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Treatment utilisation seems not to be most important for the community integration
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Group comparisons – significant results
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(p<0.005) (p<0.01)
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Group comparisons – significant results
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(p<0.05)
All: (p<0.001)
(p<0.001)
Association with the stage of integration
Significant correlations
Having been prepared for release
Having a legal income
Having a stable housing
Having a partner who not uses drugs
Self‐assessment of
having little drugs problems
and legal problems
having no major housing
problems
No associations found for
Life‐time duration and frequency of imprisonments
Having mental health problems
Age of participants
Age of onset of regular drug use
Having a job, employment after release
Utilisation of any drug treatment before/after release
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zurhold@uke.de
Conclusions
Only a minority of the respondents can be regarded as successfully integrated
(n=47; 25%)
Proportion of non integrated is highest in Germany (41%) and Hungary (50%)
Preparation for release is associated with better stage of integration (but not the
utilisation of drug treatment in or after prison)
Transition from prison to the community is strongly affected by economic and
social stability
Imprisonment often results in the loss of housing, the breakdown of
relationships, and the loss of legal sources of income/welfare benefit
Criminalisation of drug users is reflected in frequent imprisonments and long
periods of prison stays
The sample of the study was heterogeneous across the countries
Selection bias especially in Slovenia and Hungary
It was difficult to reach 50 participants according to inclusion
criteria
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