Novel Psychoactive Substances in Custodial Settings: A Mixed Method Investigation on the Experiences of People in Prison and Professionals Working With Them.

Ornella Corazza,Shanna Marrinan,Sara Coloccini,Cosimo Zene,Andreas Aresti,Caryl Watkins,Giuseppe Bersani,Attilio Negri,Sacha Darke,Antonio Metastasio,Mike Vigar,Raffaella Rinaldi

doi:10.3389/fpsyt.2020.00460

Abstract

IntroductionNovel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment. This study analyses the phenomenon from the perspective of people in prison and that of professionals working with them.MethodsA phenomenological qualitative approach was used to analyze self-reported experiences with ‘Spice’ (NPS) among users in prison. A semi-structured questionnaire was also disseminated among professionals working in these settings to better understand (a) the impact of NPS on their work; (b) perceived issues on safety in their working environment; (c) approaches used to tackle the phenomenon and best practices.ResultsPsychotic events resulting from the collected Spice accounts (5) were marked by hallucinations, depression, self-harm, and suicidal ideations. Other emerging elements included fear, paranoia, inability to be with others, mistrust, breakdown and other risky behaviors. Overall, 186 responses from prison staff were collected across the country. 67% claimed NPS to have had a deep impact on their work as they commonly witnessed espisodes involving outbursts of anger, slurred speech, hallucinations, psychosis, and significant mental deterioration among those in prison. Some 91% have witnessed aggression at least once, with 53% experiencing direct harm. Suggested interventions included enhanced training and education (84%), improved detection (92%) and treatment and support services (93%).ConclusionsFindings highlight the urgent need for joint multi-disciplinary efforts to tackle the exponential escalation of NPS in prisons as well as to facilitate the recovery and societal reintegration of those affected. Phenomenology can be recommended as a valuable methods to study drug induced experiences.

Highlights

Novel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment
Other emerging elements included fear, paranoia, inability to be with others, mistrust, breakdown and other risky behaviors
186 responses from prison staff were collected across the country. 67% claimed NPS to have had a deep impact on their work as they commonly witnessed espisodes involving outbursts of anger, slurred speech, hallucinations, psychosis, and significant mental deterioration among those in prison

Summary

Introduction

Novel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment. Novel Psychoactive Substances (NPS) pose ‘the most serious threat to the safety and security of the prison system’ [1]. NPS are typically analogs of other psychoactive substances, created in makeshift laboratories without any safety protocols or testing in humans, posing a severe health challenge for this vulnerable population and professionals working with them. Incidents of self-harm have risen by 22% from the previous year and the number of assaults increased by 5% up to June 2019, with a rate of 451 episodes of violence per 1,000 prisoners [5]. Associated violence can often extend to the wider community; the family and friends of those who are experiencing addiction or accumulating debts in prison may be pressured to provide funds or carry NPS into prison

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