HR2 – Harm Reduction & Human Rights: European human rights …

Yesterday, the BBC’s Mark Easton did a series of reports that criticised the provision of methadone in UK prisons. Using interviews with a narrow selection of commentators, primarily from abstinence-based drug service providers and 12-step groups, the reports described an allegedly chaotic situation in which the prison system was ‘doling out methadone’, where prisoners were ‘being prescribed the addictive heroin substitute methadone instead of being encouraged to get drug-free’ and that ‘voters would be shocked by how few prisoners are given the chance to get off drugs‘.

The BBC report has prompted a bit of a firestorm in the UK press, leading many commentators to uncritically adopt the conclusion that methadone is being given out ‘willy-nilly’ in prisons, without actually doing any research of their own.

Ironically, the sensationalised scenario painted by Easton and others was directly contradicted only 24-hours earlier by the European Committee for the Prevention of Torture (CPT).

The CPT is an independent human rights body based out of the Council of Europe in Strasbourg. Its mandate is to visit places of detention in Council of Europe countries to see how persons deprived of their liberty are treated and, if necessary, to recommend improvements to States. Visits are carried out by independent delegations of experts, accompanied by members of the Committee’s Secretariat.

The CPT report on its mission to the UK prisons was released 8 December 2009. It paints a very different picture than that reflected by the BBC.

Rather than a system giving out methadone hand over fist, the CPT instead found that prisoners were ‘being forced off methadone maintenance or being offered low doses without reference to clinical needs’. It found that ‘the rapid reduction in the daily doses of methadone offered to inmates was being done for administrative reasons rather than based on clinical needs’.

In contrast to the BBC’s reporting that prisoners ‘desperate to get off drugs…are still put on methadone’, the CPT found instead that ‘the reduction [in methadone dosage] was being done without the consent of the patient’.

As a result of its investigation, the CPT report ‘recommends that the United Kingdom authorities consider introducing longterm methadone maintenance’.

The CPT’s findings on the problems of methadone provision in UK prisons are indeed cause for concern, especially given their conclusions that the ‘evidence supporting methadone maintenance therapy in prison is strong (both for criminological and health outcomes)’. Unfortunately, the findings from these independent external experts fail to slot neatly into counter-narrative being constructed by some opponents of harm reduction in the UK, and as a result did not receive the attention even of those news outlets claiming to be investigating methadone services in prisons.

The relevant section from page 37 of the report is reproduced below:

‘[T]he CPT noted that prisoners were being forced off methadone maintenance or being offered low doses without reference to clinical needs, whereas the evidence supporting methadone maintenance therapy in prison is strong (both for criminological and health outcomes). The doses of methadone (or buprenorphine) need to satisfy the individual’s addictive needs, and respond to the additional risks of disease transmission while in custody, and immediately after release. Instead, it appeared that the rapid reduction in the daily doses of methadone offered to inmates was being done for administrative reasons rather than based on clinical needs, and the reduction was being done without the consent of the patient. Further, prisoners taking methadone were apparently not offered work opportunities, although there is no reason why they should not work The CPT understands that a new programme, Integrated Drug Treatment Services, will tackle some of these concerns.

The CPT recommends that the United Kingdom authorities consider introducing longterm methadone maintenance, and that the new Integrated Drug Treatment Services programme takes into consideration the above remarks.‘