Summarizes measures used in different European prison systems to identify drug abusers among prisoners, treat their dependence, and manage their many other special health problems. Particular attention is given to the ethical issues surrounding the treatment of prisoners against their will and to the special problem of motivation within a prison environment. Health problems related to drug abuse, including AIDS and suicide, are also critically assessed. Throughout, examples of systems and procedures currently in effect are contrasted with measures needed to cope with both the explosive growth of drug abuse in Europe and the high rate of seropositivity for HIV currently found in the prison populations of Europe. The opening section outlines the information that should be gathered and screening tests that should be performed in order to identify drug abusers among new admissions. Other sections offer advice on treatment using prescribed drugs and professional counselling, and summarize national experiences using voluntary and non-voluntary treatment schemes, noting some evidence that non-voluntary treatment can be of value. A section devoted to the special problems of AIDS and suicidal behaviour lists eight concrete measures needed for the control of HIV infection in prisons and for the prevention of harmful overreactions among staff and inmates. Advice on the prevention of suicide is presented in the form of six predictors of suicidal behaviour and the corresponding preventive measures that should be followed by prison staff and counsellors.

DC.-EURO

eng.

ita.

WHODOC

WHO monograph

4