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East Mediterr Health J. 2017 May 1;23(3):222-230.

Public health alternatives to incarceration for drug offenders.

Author information

Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
Programme of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, United States of America.


in English, Arabic, French

Drug users are vastly overrepresented in prison populations. Once inside they face increased risks of acquiring infections such as HIV, hepatitis and TB, and on release they face an elevated risk of fatal overdose. Relapse and recidivism are the norm following release from prison. The implementation of evidence-based drug treatment programmes in prison is rare, yet drug treatment in prison reduces the transmission of infections, recidivism and fatal overdose on release. Recognising the negative returns associated with incarceration, many jurisdictions have begun to consider alternatives such as depenalisation of the personal use of illicit drugs, provision of treatment and social reintegration of drug offenders, and a shift in focus from supply reduction to demand and harm reduction measures in the community and in prison. Women with drug problems are twice as likely to have been imprisoned for a drug offence as incarcerated men. Similarly, HIV prevalence is higher among female inmates. Serious attention should be paid to implementation of non-custodial sentences for women, particularly during pregnancy and those with young children.

[Indexed for MEDLINE]

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