Unless prisoners have a good place to live after release, prison drug rehabilitation won’t work

A far larger proportion of prisoners have histories of dependent substance use than the general population. Anthony Devlin/PA Wire/

Drug recovery work in prison is largely futile unless suitable accommodation and support are available to prisoners upon their release. That is the finding of newly published research I have led that analysed the effectiveness of ten pilot projects within prisons aimed at getting prisoners off drugs and alcohol and reintegrated into communities.

Our research showed that some of these pilots, known as Drug Recovery Wings (DRWs) showed promise, involving dedicated staff and highly motivated prisoners. But too often these prisoners faced a “cliff edge” of support on release. Many became homeless or resorted to living in chaotic, “crackhead” hostels, bed and breakfasts and night shelters. There is a pressing need to identify new approaches that can link effective treatment in prisons with proper, well-funded support on release.

The ten pilot DRWs were set up during 2011 and 2012 and, with £30,000 each to cover initial costs, they were given considerable license to develop their own models to reflect local needs. The resulting pilots were very varied: capacity ranged from 20 to 140 beds and therapeutic content from structured full-time programmes to the basic support offered elsewhere in the prison. Some were run by uniformed prison officers, others by third sector treatment professionals, and some were carefully segregated from the rest of the prison while others shared the wider regime.

My colleagues and I were funded by the National Institute of Health Research to undertake a substantial evaluation of these pilots. We found that some of the DRWs were promising, with prisoners expressing strong motivation to make changes in their lives and survey data showing a significantly higher quality of life on the wings compared to other locations in the prison. Key to their success appeared to be a mixture of physical separation from the rest of the prison and protection of beds in the wings only for prisoners engaged in the programme. A strong sense of community and good relations between prisoners and staff who were strongly committed to the programme were also important.

HMP Bristol, the site of one of the ten pilot drug recovery wings. Barry Batchelor/PA Wire

Life after release

We surveyed 109 prisoners after they had been living back in the community for six months. Comparing the six months prior to custody with the six months following release, there were considerable reductions in drug and alcohol use, and self-reported offending. However, as we did not have another group of prisoners to compare these to, these reductions cannot be attributed to DRWs.

We also interviewed a group of 36 prisoners six months after their release from a DRW, which gave us a more detailed picture of the lives they were leading outside prison. We found that a major obstacle to prisoners’ continuing recovery was the absence of acceptable accommodation. Most commonly, they had been released to a hostel or local authority-funded bed and breakfast. These were almost universally described as deeply unpleasant environments. One man from Manchester told us:

There were a lot of drugs. It was a horrible place. It was worse than jail.

Others were released homeless. One man from Brixton told us:

Nothing. Nothing. I came out with 50 quid in my pocket, street homeless. No hostel, no night shelter, nothing. I was down housing every day looking for a place, but nothing come up.

Where we could, we also interviewed people providing support to the ex-prisoners, usually their partners or parents. These interviews often elicited the most poignant narratives. One woman from Swansea, the parent of an ex-prisoner, told us:

Well I suppose it’s just continuously feeling for years that you’re not getting anywhere. And always keep on going in spite of having police in the house and raiding the house… And sort of breaking your heart seeing his life is going by and no changes for him, you know?

Support on the outside

We concluded that while some DRWs offered promising approaches inside prison, without continuing help on release, such efforts were often in vain, with prisoners’ plans for making radical changes to their lives swiftly evaporating upon release. Much more needs to be done to help such prisoners on release from prison, linked more effectively to therapeutic work in prison.

This study has also led us to question what is really meant by the use of the word “recovery” in a prison setting. Two influential American researchers in the drug recovery field have pointed to the importance of “recovery capital”, which they define as: “The sum total of one’s resources that can be brought to bear in an effort to overcome alcohol and drug dependency.”

Imprisonment inevitably erodes people’s recovery capital by reducing contact with family and friends, lessening the chances of finding suitable accommodation and employment, and exacerbating mental health problems. Prison “recovery” programmes may therefore best be aimed at limiting this damage: by working to maintain links with families and gain employment skills while inside. They can also provide an environment that can foster and support a commitment to moving on from drug use and offending – as the best DRWs did. Yet, everything depends on what then happens when they walk through those prison gates.