School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia.
The Canberra Hospital, Garran ACT, Australia.
Crim Behav Ment Health. 2023 Feb;33(1):62-71. doi: 10.1002/cbm.2273. Epub 2023 Jan 30.
Research shows that the prevalence of substance use disorders among the prison population is high globally. Although prisons are highly controlled environments, access to drugs and other substances in prison remains a major problem. Yet, previous research is focussed mainly on the Western context, with the studies generally reporting on lifetime prevalence without reference to whether the disorders are manifest even within the controlled environment.
To estimate the prevalence of substance use disorders evident while in prison in Ghana and associated risk indicators. For these purposes, substance use disorder was defined by any indication of dependency, or escalating use or socially problematic use during the 12 months of imprisonment prior to the interview.
The study involved 500 adults (443 men and 57 women) in a medium-security prison in Ghana who had served at least 1 year of a prison sentence. Participants' alcohol use disorder was assessed separately from other substance use disorders which included cannabis, cocaine and other stimulants using the Mini International Neuropsychiatric Interview (MINI); it is a structured interview and diagnostic tool for major psychiatric and substance use disorders in DSM-5 and ICD-10.
Two percent of the 500 participants had used alcohol to the level of alcohol use disorder, and 6% had other substance use disorders in 12 months prior to interview and while in prison. Cannabis (4%) and stimulants (3%) were the most frequently reported substance use disorders. Logistic regression model estimates indicate that younger age, prior offending and alcohol use dependence were significantly associated with such disorders in prison.
In spite of efforts to prevent substance use in prison, nearly one in 10 of these prisoners were using alcohol or illicit drugs to a level indicative of substance use disorders. Our findings suggest that prioritising brief assessment may help identify those in most need of clinical help to limit their alcohol and illicit substance use problems.
研究表明，全球范围内监狱人口的物质使用障碍患病率很高。尽管监狱是高度受控制的环境，但在监狱中获得毒品和其他物质仍然是一个主要问题。然而，之前的研究主要集中在西方背景下，这些研究通常报告的是终身患病率，而没有提到这些障碍是否在受控制的环境中表现出来。
估计加纳监狱内明显的物质使用障碍的患病率以及相关的风险指标。为此，物质使用障碍被定义为在入狱前 12 个月内任何依赖、使用量增加或社会问题使用的迹象，无论是否在受控环境中表现出来。
这项研究涉及加纳一所中等安全监狱的 500 名成年人（443 名男性和 57 名女性），他们至少服完 1 年刑期。参与者的酒精使用障碍与其他物质使用障碍（包括大麻、可卡因和其他兴奋剂）分开评估，使用的是 Mini International Neuropsychiatric Interview（MINI）；这是一个用于 DSM-5 和 ICD-10 中主要精神和物质使用障碍的结构化访谈和诊断工具。
500 名参与者中有 2%的人饮酒达到酒精使用障碍的水平，6%的人在入狱前 12 个月和入狱期间有其他物质使用障碍。大麻（4%）和兴奋剂（3%）是最常报告的物质使用障碍。逻辑回归模型估计表明，年龄较小、先前犯罪和酒精使用依赖与监狱中这些障碍显著相关。
尽管监狱努力防止物质使用，但这些囚犯中仍有近十分之一的人使用酒精或非法药物达到物质使用障碍的水平。我们的发现表明，优先进行简短评估可能有助于确定最需要临床帮助以限制其酒精和非法物质使用问题的人。
