Substance use disorders in the Norwegian prison population: Needs, treatment, and post-release outcomes

Abstract

The global prison population continues to grow annually, while the number imprisoned in Norway each year has decreased over decades. Concurrently, those who end up in prison have become an increasingly marginalized group, characterized by escalating socio-economic challenges and mental health disorders. Particularly, substance use disorders are more prevalent among incarcerated individuals compared to the general population. This dissertation examines substance use disorders among people in prison in Norway, the negative consequences associated with high-risk drug use, and the utilization of drug use disorder treatment during imprisonment. The dissertation has followed a cohort of 733 individuals who were imprisoned in 2013-2014, following them until the end of 2019 through Norwegian registries. More than 40% had high-risk drug use, 18% had a likely alcohol dependence, and 47% were likely dependent on alcohol and/or drugs. More than half of individuals with a likely substance use disorder were re-incarcerated within 1000 days after release, and they had a four times higher risk of re-incarceration compared to individuals with low-risk substance use. More than 60% of people with high-risk drug use received treatment for drug use during incarceration. The use of multiple substances, injecting drug use, longer sentences, and Nordic origin were associated with receiving treatment. The results highlight the high prevalence of substance use disorders and social marginalization among individuals in Norwegian prisons. This underscores the necessity of systematic screening for substance use disorders among incarcerated individuals and a significant need for follow-up and treatment. Future research should examine the extent and quality of current treatment, as well as its effectiveness in improving health outcomes, reducing recidivism, and enhancing the well-being of people in prison.