Substance Use After Release from Prison

Abstract

This chapter discusses the substantial proportion of prisoners globally who have a history of alcohol, tobacco, and other drug use and dependence. Incarceration usually provides a period of abstinence or reduced substance use, but this reduction is often transientand many ex-prisoners rapidly return to pre-incarceration levels of substance use. Substance use after release from prison is affected by both individual factors, such as substance use history and personal expectations, and interpersonal factors, such as social networks. Released prisoners often return to environments in which drugs are readily available and substance use is accepted or normative. Structural factors, such as poor access to substance use treatment and other health services, unstable housing and limited employment options, can create additional stressors that increase the risk of harmful substance use. Given the paucity of epidemiological evidence, the natural history of substance use after release from prison remains poorly understood. In particular, there is a dearth of evidence relating to resumption of alcohol, tobacco, and non-injecting illicit drug use following release from prison. Furthermore, although substance use in ex-prisoners is affected by structural and interpersonal factors, interventions to address problematic substance use typically focus on the individual. Additional research in this area is urgently needed to inform evidence-based policies and interventions.