Our seamless drugs rehab service offers continuity of care to offenders
Nursing team’s care for people who misuse psychoactive substances extends from community to custody
Nursing team’s care for people who misuse psychoactive substances extends from community to custody, says Karen Blatherwick of Turning Point
Helping offenders come off drugs and alcohol is a crucial job for nurses working in prisons. Detoxing is hard for anyone, but it’s particularly tough for someone who is in custody, where access to drugs and alcohol is prohibited.
People in prison experience physical and psychological withdrawal symptoms such as cravings and low mood, and are at risk of self-harm or even suicide. That’s why support in custody that mirrors what is available in the community is essential.
Treatment stabilises drug-taking and alcohol misuse, with the result that people are less likely to re-offend on release.
Since last year I’ve been working at Leicester Prison where my organisation, the charity Turning Point, has taken an innovative approach to help people on their recovery journey. In the past, several different bodies provided substance misuse services across Rutland, Leicestershire and the city of Leicester, including in the prison.
Turning Point, which offers a drug and alcohol treatment services, has a substance misuse team in Leicestershire that works in the community and in the prison, so any work that started before someone was arrested and charged can continue in prison.
Prisoners benefit because they may see a familiar face when they arrive here, and the team has access to their case notes.
‘There’s a belief that novel psychoactive substances are safe because they were legal, cheap and easily available’
One challenge is working with prisoners on short sentences. Often, they’re released before they can complete or even start recovery work or rehabilitation, resulting in them being locked in a cycle of rehab and relapse. Having community workers in prison enables us to continue treatment once someone is released.
Everyone who comes through the doors is automatically seen by a member of the substance misuse team and offered harm-reduction advice. This doesn’t happen at every prison – often new arrivals just see a general nurse in reception.
At Leicester Prison we prescribe pharmacological interventions if required from day one, and provide on-call cover as well as nurse support. Anyone who needs medication gets it.
We encourage prisoners’ active involvement
Anyone wanting to engage is allocated a key worker. We draw up care plans for every individual, including specific aims focusing on education and health. Prisoners are provided with work packs containing activities for them to complete in their cells, which are then marked. It’s about them taking ownership instead of just sitting in a classroom and being talked at.
If it’s relevant, the packs include information about the risks of novel psychoactive substances (NPS), formerly known as legal highs. These drugs, which include Spice, are on the rise in prisons.
At Leicester Prison there’s a robust NPS strategy and we work alongside security, getting daily briefings on prisoners known to be taking Spice.
Misapprehension about substance safety
The challenge is that many don’t regard NPS use as an addiction – there’s a belief that it’s safe because it was legal, cheap and easily available in the community. To combat this, our team follows up anyone who experiences an NPS event – in which a person may vomit, pass out or become aggressive.
We offer them support. Earlier this year there was an inmate who declined treatment until he'd experienced about half a dozen NPS events. Then he reached out to us.
Often people take drugs or misuse alcohol as a way of coping. Many prisoners I come across take drugs while they’re inside because of boredom or underlying emotional issues.
‘Prisoners should not be punished again by not getting access to treatment or be told they can’t change’
We offer them alternative coping strategies such as putting them in contact with people they can talk to about their problems. There’s a self-help group called Dear Albert that meets once a fortnight. It includes former service users who can meet released prisoners at the gate and take them to appointments.
An average of 55 to 60 patients were in clinical treatment at any one time in the six months to the end of November 2017, with around 40% on reducing regimens. In the same period, 40 patients successfully undertook alcohol detoxification.
A recent report by HM Inspectorate of Prisons and the Care Quality Commission highlighted the ‘excellent’ services provided by Turning Point and the high-quality care, especially for those with a dual diagnosis of mental health problems and a drug and/or alcohol issue.
Potential to recover
I believe that everyone has the potential to recover, given the right support. What I’ve learned in my 18 years working in substance misuse is that addiction can affect anyone – and you should never give up on a person.
Prisoners are already being punished by being in jail. They should not be punished again by not getting access to treatment, or be told they can’t change. It’s a hard journey – people don’t just wake up one day, their habit gone.
The work of the substance misuse team at Leicester Prison underlines the importance of nurses in addiction recovery. We don’t just take blood pressure – we support people facing serious challenges with substance misuse too. And that involves building relationships and never giving up on those in society who others have written off.
Karen Blatherwick is nurse manager at Turning Point