4. ADDICTIONS
Introduction
4.1 The Barlinnie Drug Services team consists of eight officers who are managed by the drug strategy co-ordinator. They are responsible for delivering addiction related programmes and for the supervision and management of the mandatory drug testing process. The drug services team also support the work of the addictions nurses and their responsibilities include the management and supervision of:
- The doctor's admission process
- Addiction nurses screening and urinalysis assessments
- Blood borne virus clinics
- Smoking cessation advice clinics
4.2 The Drug Services team work closely with the Enhanced Addiction Casework Team (Phoenix House). The drug strategy co-ordinator oversees the contract and the team manager (Phoenix House) links with him on a day-to-day basis.
Addiction Services
4.3 There is a good range of services provided for prisoners with addictions. All prisoners are provided with a harm reduction session at induction. All prisoners serving more than two years will also be offered a pre-release harm reduction session. Those prisoners serving more than 30 days have access to the full range of services. Those who are assessed as having an identified need, and who wish it, are referred to Phoenix House who will complete the Common Addiction Assessment Recording Tool and draw up a care plan.
4.4 There is however an exception to this. Phoenix House are not contracted to work with sex offenders. There is an expectation that this will change when the contract is changed in 2007, and Barlinnie have partly addressed this gap by offering an alcohol awareness group to these prisoners. During a focus group from this hall prisoners said that this alcohol awareness group was valued and helpful.
4.5 Motivational interviewing is provided to prisoners, working on a one-to-one basis with Phoenix House. This is also provided to prisoners when they are being assessed for entry to programmes.
4.6 There are two programmes offered:
4.7 First Steps targets those in the early stages of drug taking. This programme was devised by Barlinnie. Lifeline is an approved activity and is supported by psychologists. All convicted prisoners are eligible to be referred to these programmes. Referrals come via the core screening system on PR2, from hall staff, or through Phoenix House. Referrals are subject to a local sift board. The length of sentence is taken into account to ensure that the prisoner has enough time left to serve in order to complete the programme. There are waiting lists for both programmes.
4.8 Phoenix House provides individual sessions to prisoners based on identified need, outlined in their care plan. This work is carried out in the halls. The frequency of these sessions is based on individual needs, but is on average every four to six weeks. Phoenix House staff recognise this is not always enough. They would prefer to have enough time to be able to see people every two weeks.
4.9 Methadone is prescribed to those prisoners who have been receiving it in the community when they are admitted. This is checked by contacting the community service and by testing the prisoner's urine. The doctor can prescribe methadone to prisoners who have not been receiving it prior to admission but this is not common. Numbers of prisoners receiving methadone have been increasing. This reflects what is happening in the community.
4.10 Random drug testing is to be carried out in September, October and November 2006. Thereafter it will move to anonymous addiction prevalence testing. The addictions team and health centre were preparing for this at the time of inspection. Progression drug testing is also offered to prisoners being considered for open conditions. Testing is also carried out if prison staff have suspicions that a prisoner is misusing drugs.
4.11 Advice on smoking cessation is currently being offered by Phoenix House. Four Phoenix staff and two addiction nurses are undertaking training to allow them to offer a more comprehensive service, including groups. There is already a waiting list for this but they hope to be able to start groups soon.
4.12 Alcoholics Anonymous come to Barlinnie twice a week and hold meetings in the halls. These are open to all prisoners who want to attend. Narcotics Anonymous have recently re-established their relationship with the prison. They plan to run sessions every second week. It will be made available discretely and admission will not be limited in any way.
Partnership Working
4.13 There are good working relationships between all the partners involved in delivering addiction services in Barlinnie. Staff share information and co-ordinate their work with prisoners. The inspection team heard that there was currently no multi-disciplinary addictions meeting where all of the agencies involved could get together to discuss cases. There is, however, a plan to restart the Addictions Monitoring Group which would fulfil this role.
Throughcare Addiction Service
4.14 Phoenix House refers prisoners to Throughcare Addiction Services ( TAS) for voluntary aftercare. If the prisoner was receiving an addictions service before they came into prison they are referred back to that service. If the prisoner is taking methadone they will do this jointly with the addiction nurses. Some prisoners do not want to be referred to TAS and addictions staff believe this to be due to the intensity of the service. When prisoners do want to be referred, however, they do not always get the service they require. The community services are not yet available in all areas.
HOPE Family and Addictions Support Project
4.15 This project provides input to the First Steps and Lifeline programmes. It focuses on prisoners' relationships with their families, in particular with their children. The material is sourced from a number of existing parenting programmes. It has been adapted to make it more appropriate for prisoners on the addiction programmes.
Accommodation
4.16 The accommodation in the addictions unit is very good. The rooms used for programmes and groups are comfortable and offer an appropriate environment for the work. Accommodation for individual work, however, is not as good. Due to overcrowding in the halls there is very limited space to work with prisoners individually. The perspex booths which have to be used for this purpose do not offer sufficient confidentiality or comfort. As they lack ventilation the door should be opened at least every 15 minutes. Phoenix House staff regularly carry out individual sessions which last forty minutes.