Substance abuse work

The substance abuse strategy of the prison services provides a framework for the development of substance abuse work. The practical application is realised at local level. The goal of the substance abuse strategy is to:

• Prevent the supply of substances and substance-related criminality

• Prevent the harms caused by substance abuse

• Prevent the demand for substances

• Secure the rehabilitation continuum of a person with substance abuse problem from freedom and to freedom

• Form networks in the operating environment

Substance abuse work is divided into substance abuse treatment, substance abuse rehabilitation and substance control. Substance abuse treatment, which is mainly carried out by the health care personnel, includes, among others, substance abuse evaluation, detoxification and withdrawal treatment, psychiatric treatment for substance abusers as well as substitute and maintenance treatment of opioid addicts. Substance abuse rehabilitation comprises rehabilitative activities, which are realised in the form of individual work or different substance abuse programmes. The substance control in prisons consists of, for instance, the supervision of the abstinence from substances and the execution of inspections.

Prisoners are guided to activities through the assessment centre, where they are assessed and the plan for their sentence term is made. Nearly all prisons arrange substance abuse rehabilitation. The goal of short motivation programmes is to share information on substance abuse rehabilitation and motivate to lead a life without intoxicating substances. Longer group programmes are usually based on cognitive behavioural therapy and consist of exercises, lectures and discussions supporting a life without crimes and intoxicating substances. In addition, the prison services also use a few community treatment programmes.

In addition to the programmes, also individually realised substance abuse rehabilitation is very significant. All prisoners do not want to or cannot participate in a group activity in which case they can discuss the issues and problems related to abstinence from substances and substance use with an instructor regularly. Individual discussions are also used as follow-up treatment in many substance abuse programmes.

A ward division, which supports substance abuse rehabilitation, makes it possible that some prisoners participating in programmes live in a contract ward where they commit themselves to abstinence from substances. All open prisons are substance-free and a precondition for a placement in an open prison is that the prisoner commits to abstinence from substances and to random testing. Furthermore, prisoners can take part in peer group activities, such as AA and NA groups, in many prisons.

Prisoners who have undergone the prison’s substance abuse rehabilitation can also be placed in an outside substance abuse treatment or rehabilitation institution for a period of six months at most if it is considered to promote rehabilitation. Prisoners, who are addicted to intoxicating substances, can also benefit from other activity programmes, which do not actually include substance abuse rehabilitation. For example, Behaviour-Interviewing-Change Programme BSF, which is based on a motivating interview, stimulates change as well as problem solving and social skills, and Cognitive Skills Programme, which focuses on reviewing the consequences, prepares for a life without intoxicating substances and, thus, both programmes are also suitable for prisoners with substance abuse problems. Furthermore, various programmes preparing for freedom, the family camps as well as rehabilitating work activities include quite a few elements supporting the handling of substance abuse problems and a life without substances although they are not actual substance rehabilitation.

Substitute treatment of opioid addicts

The Decree of the Ministry of Social Affairs and Health on the detoxification and substitution treatment of opioid addicts with certain medicinal products is carried out in collaboration with the prisoner and the health care services provided in freedom. When considering the participation in substance rehabilitation and activities, the accommodation and the allocation to an open prison, prisoners receiving substitute treatment are assessed based on their perceived functioning capacity, needs and risks the same way as other prisoners.