Exploring motivations to stop injecting in English prisons: qualitative research with former male prisoners

• Date: 14 June 2013
• Pages: 68-81
• Published date: 14 June 2013
• DOI: https://doi.org/10.1108/17449201311326943
• Author: Charlotte N.E. Tompkins
• Subject Matter: Health & social care,Public policy & environmental management,Sociology

Exploring motivations to stop injecting in

English prisons: qualitative research with

former male prisoners

Charlotte N.E. Tompkins

Abstract

Purpose – This paper aims to explore the cessation of injecting amongst male drug users when in

prison in England and uncovers what influenced this behaviour and why.

Design/methodology/approach – Qualitative interviews were conducted with 30 male drug users on

release from prison to explore what happened to their injecting drug use in prison. The research was

conducted from a pragmatic harm reduction approach using grounded theory.

Findings – Not injecting in prison was identified as a pertinent finding and nine overarching themes

accounted for this decline. The themes often overlapped with one another, highlighting how the decision

not to inject when last in prison was multi-factorial. Running throughout the themes were participants’

concerns regarding the health and social risks attributed to injecting in prison, alongside an

appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users

when in prison.

Originality/value – This qualitative research offers an updated perspective on illicit drug injecting in

prison in England from the view of drug users since health and prison policy changes in prescribing and

practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and

recovery from injecting drug use.

Keywords Injection drug use, Prisons, Prisoners, Men, Qualitative, Interviews, Harm reduction,

Public health, Grounded theory, Imprisonment, Drugs

Paper type Research paper

Introduction

The practice of injecting illicit drugs is considered high risk due to some of the potential health

and social consequences, particularly as use becomes more routine (Berridge and Robinson,

2003). For example, injecting is thought to be the main cause of health damage related to illicit

drug use in contemporary Europe (European Monitoring Centre for Drugs and Drug

Addiction, 2001; Towl,2006), encompassing physical and mental morbidity and an increased

risk of mortality through the early onset of disease or fatal drug overdose. Despite these risks,

injecting is a popular way of administering illicit drugs due to the instant ‘‘hit’’ seconds after

administration as the drugs quickly travel in the bloodstream to the brain (Neale, 2002) and the

lesser amount needed to obtain a hit in comparison to other administration routes.

Intravenously injecting in prison environments has been identified to carry high, sometimes

higher risks than community injecting (European Monitoring Centre for Drugs and Drug

Addiction, 2012; Ju

¨rgens et al., 2009; Shewan et al., 2005; World Health Organization,

2005). This is due to a number of reasons, including the reduced access to sterile injecting

materials in some prisons, which may result in the sharing of previously used (and therefore

possibly infected) injecting equipment (Hughes, 2001; Ju

¨rgens et al., 2009; Wright et al.,

2005). Indeed, prisons are high risk environments for the spread of blood borne viruses

such as HIV/AIDS and hepatitis (United Nations Office on Drugs and Crime, 2011), partly

due to unsterile injecting drug use and/or tattooing practices which may take place

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INTERNATIONAL JOURNAL OF PRISONER HEALTH

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VOL. 9 NO. 2 2013, pp. 68-81, QEmerald Group Publishing Limited, ISSN 1744-9200 DOI 10.1108/17449201311326943

Charlotte N.E. Tompkinsis a

Research Fellow based at

Leeds Community

Healthcare NHS Trust,

Leeds, UK.

With thanks to the men who took

part and shared their stories,

to Dr Mitch Waterman,

Dr Anna Madill and

Dr Nat Wright. Thanks also to

the Harold Hyam Wingate

Foundation and the Max

Hamilton Research Fund,

University of Leeds. The views

expressed are those of the

author.