The risk matrix : drug-related deaths in prisons in England and Wales, 2015-2020

Article


Duke, K., Gleeson, H., MacGregor, S. and Thom, B. 2023. The risk matrix : drug-related deaths in prisons in England and Wales, 2015-2020. Journal of Community Psychology. 2023. https://doi.org/10.1002/jcop.22989
TypeArticle
TitleThe risk matrix : drug-related deaths in prisons in England and Wales, 2015-2020
AuthorsDuke, K., Gleeson, H., MacGregor, S. and Thom, B.
Abstract

Aims: This article explores the factors contributing to drug-related deaths in English and Welsh prisons between 2015-2020.
Methods: Based on content analysis of all Prison and Probation Ombudsman ‘other non-natural’ fatal incident investigation reports, descriptive statistics were generated. Qualitative analysis explored the circumstances surrounding deaths and key risk factors.
Results: Most deaths were of men, whose mean age was 39 years. Drug toxicity was a main factor in causing death, exacerbated by underlying physical health conditions and risk-taking behaviours. A variety of substances were involved. New psychoactive substances became more important over time. A high proportion had recorded histories of substance use and mental illness. During this period, the prison system was under considerable stress creating dangerous environments for drug-related harm.
Conclusion: This study highlights the process of complex interaction between substances used, individual characteristics, situational features and the wider environment in explaining drug-related deaths in prisons. Implications for policy and practice are discussed.

Keywordsdrug-related deaths; England and Wales; mental health; new psychoactive substances; prisons; risk behaviours; substance use
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherWiley
JournalJournal of Community Psychology
ISSN0090-4392
Electronic1520-6629
Publication dates
Online05 Jan 2023
Publication process dates
Deposited06 Jan 2023
Submitted23 Sep 2022
Accepted22 Dec 2022
Output statusPublished
Publisher's version
License
Accepted author manuscript
File Access Level
Restricted
Copyright Statement

© 2023 The Authors. Journal of Community Psychology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Digital Object Identifier (DOI)https://doi.org/10.1002/jcop.22989
Web of Science identifierWOS:000907538400001
LanguageEnglish
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Thom, B., Beccaria, F., Bjerge, B., Duke, K., Eisenbach-Stangl, I., Herring, R., Holmila, M., Houborg, E., Asmussen Frank, V., Moskalewicz, J., Rolando, S., Thickett, A., Warpenius, K. and Welbel, M. 2015. Stakeholder ownership: a theoretical framework for cross national understanding and analyses of stakeholder involvement in issues of substance use, problem use and addiction. ALICE RAP European Commission.
Delivering alcohol IBA: is there a case for mainstreaming? Insights from an expert workshop and from the published literature
Thom, B., Herring, R. and Bayley, M. 2015. Delivering alcohol IBA: is there a case for mainstreaming? Insights from an expert workshop and from the published literature. Alcohol Research UK.
The prison population and drug use
Duke, K. and Kolind, T. 2015. The prison population and drug use. in: Kolind, T., Thom, B. and Hunt, G. (ed.) Handbook on Drug and Alcohol Studies – Social Science Perspectives Sage.
The normalisation of binge drinking? An historical and cross cultural investigation with implications for action
Berridge, V., Thom, B. and Herring, R. 2007. The normalisation of binge drinking? An historical and cross cultural investigation with implications for action. Alcohol Research UK.
Implementation of the Licensing Act 2003: a national survey
Foster, J., Herring, R., Waller, S. and Thom, B. 2008. Implementation of the Licensing Act 2003: a national survey. Alcohol Research UK.
Women in recovery
Thom, B. 2010. Women in recovery. in: Yates, R. and Malloch, M. (ed.) Tackling Addiction Pathways to Recovery London Jessica Kingsley.
Drinking contexts and youth drunkenness
Thom, B. 2011. Drinking contexts and youth drunkenness. in: Fox, A. and MacAvoy, M. (ed.) Expressions of Drunkenness (Four Hundred Rabbits) New York Routledge.
Perspectives on alcohol use in a traveller community: an exploratory case study
Hurcombe, R., Bayley, M., Thickett, A. and Thom, B. 2012. Perspectives on alcohol use in a traveller community: an exploratory case study. Ethnicity and Inequalities in Health and Social Care. 5 (3), pp. 89-97. https://doi.org/10.1108/17570981211319384
Drinking terms and concepts: their meaning and use
Thickett, A., Allaste, E., Kasia, K., Moskalewicz, J. and Thom, B. 2013. Drinking terms and concepts: their meaning and use. Drugs: Education, Prevention, and Policy. 20 (5), pp. 375-382. https://doi.org/10.3109/09687637.2013.798263
Producing the 'problem of drugs': a cross national-comparison of ‘recovery' discourse in two Australian and British reports
Lancaster, K., Duke, K. and Ritter, A. 2015. Producing the 'problem of drugs': a cross national-comparison of ‘recovery' discourse in two Australian and British reports. International Journal of Drug Policy. 26 (7), pp. 617-625. https://doi.org/10.1016/j.drugpo.2015.04.006
Stakeholder influences on drug and alcohol policy processes
Asmussen Frank, V., Bjerge, B., Duke, K., Klein, A. and Stothard, B. 2015. Stakeholder influences on drug and alcohol policy processes. Drugs and Alcohol Today. 15 (4), pp. 177-180. https://doi.org/10.1108/DAT-10-2015-0060
The shifting roles of medical stakeholders in opioid substitution treatment: a comparison between Denmark and the UK
Bjerge, B., Duke, K. and Frank, V. 2015. The shifting roles of medical stakeholders in opioid substitution treatment: a comparison between Denmark and the UK. Drugs and Alcohol Today. 15 (4), pp. 216-230. https://doi.org/10.1108/DAT-07-2015-0033
Tackling drugs locally: the implementation of drug action teams in England
Duke, K. and MacGregor, S. 1997. Tackling drugs locally: the implementation of drug action teams in England. London HMSO. https://doi.org/9780114301460
Activating local networks: a comparison of two community development approaches to drug prevention
Duke, K., MacGregor, S. and Smith, L. 1996. Activating local networks: a comparison of two community development approaches to drug prevention. London Home Office Drugs Prevention Initiative. https://doi.org/9781858935560
Vietnamese refugees since 1982
Duke, K. and Marshall, T. 1995. Vietnamese refugees since 1982. London HMSO.
The resettlement experiences of refugees in the UK: main findings from an interview study
Duke, K. 1996. The resettlement experiences of refugees in the UK: main findings from an interview study. Journal of Ethnic and Migration Studies. 22 (3), pp. 461-478. https://doi.org/10.1080/1369183X.1996.9976550
Delivering alcohol IBA: broadening the base from health to non-health contexts: review of the literature and scoping
Thom, B., Herring, R., Luger, L., Annand, F., Alcohol Research UK and Middlesex University 2014. Delivering alcohol IBA: broadening the base from health to non-health contexts: review of the literature and scoping. London Alcohol Research UK.
Stigma as a public health tool: implications for health promotion and citizen involvement
Williamson, L., Thom, B., Stimson, G. and Uhl, A. 2014. Stigma as a public health tool: implications for health promotion and citizen involvement. International Journal of Drug Policy. 25 (3), pp. 333-335. https://doi.org/10.1016/j.drugpo.2014.04.008
The role of evidence and the expert in contemporary processes of governance: the case of opioid substitution treatment policy in England
Duke, K. and Thom, B. 2014. The role of evidence and the expert in contemporary processes of governance: the case of opioid substitution treatment policy in England. International Journal of Drug Policy. 25 (5), pp. 964-971. https://doi.org/10.1016/j.drugpo.2014.01.015
Disruptive innovations: the rise of the e-cigarette
Stimson, G., Thom, B. and Uhl, A. 2014. Disruptive innovations: the rise of the e-cigarette. International Journal of Drug Policy. 25 (4), pp. 653-655. https://doi.org/10.1016/j.drugpo.2014.05.003
Perceptions on the role of evidence: an English alcohol policy case study
Toner, P., Lloyd, C., Thom, B., MacGregor, S., Godfrey, C., Herring, R. and Tchilingirian, J. 2014. Perceptions on the role of evidence: an English alcohol policy case study. Evidence and Policy. 10 (1), pp. 93-112. https://doi.org/10.1332/174426514X13899745453819
Reforming the Soviet model: alcohol treatment services in Kazakhstan
Waters, E. and Thom, B. 2008. Reforming the Soviet model: alcohol treatment services in Kazakhstan. Addiction Research & Theory. 16 (4), pp. 319-330. https://doi.org/10.1080/16066350802008652
Substitution treatment in the era of recovery: an analysis of stakeholder roles and policy windows in Britain
Duke, K., Herring, R., Thickett, A. and Thom, B. 2013. Substitution treatment in the era of recovery: an analysis of stakeholder roles and policy windows in Britain. Substance Use and Misuse. 48 (11), pp. 966-976. https://doi.org/10.3109/10826084.2013.797727
Stakeholders in opioid substitution treatment policy: similarities and differences in six European countries
Thom, B., Duke, K., Frank, V. and Bjerge, B. 2013. Stakeholders in opioid substitution treatment policy: similarities and differences in six European countries. Substance Use and Misuse. 48 (11), pp. 933-942. https://doi.org/10.3109/10826084.2013.797720
Containing contradictions: the development of prison drugs policy in England since 1980
Duke, K. 1999. Containing contradictions: the development of prison drugs policy in England since 1980. PhD thesis Middlesex University School of Social Science
Soft methods, hard targets: regional alcohol managers as a policy network
Lloyd, C., Thom, B., MacGregor, S., Herring, R., Godfrey, C., Toner, P. and Tchilingirian, J. 2014. Soft methods, hard targets: regional alcohol managers as a policy network. Journal of Substance Use. 19 (4), pp. 319-326. https://doi.org/10.3109/14659891.2013.808710
The alcohol improvement programme: evaluation of an initiative to address alcohol-related health harm in England
Thom, B., MacGregor, S., Godfrey, C., Herring, R., Lloyd, C., Tchilingirian, J. and Toner, P. 2013. The alcohol improvement programme: evaluation of an initiative to address alcohol-related health harm in England. Alcohol and Alcoholism. 48 (5), pp. 585-591. https://doi.org/10.1093/alcalc/agt052
From crime to recovery: the reframing of British drugs policy?
Duke, K. 2012. From crime to recovery: the reframing of British drugs policy? Journal of Drug Issues. 43 (1), pp. 39-55. https://doi.org/10.1177/0022042612466614
Partnerships: survey respondents' perceptions of inter-professional collaboration to address alcohol-related harms in England
Thom, B., Herring, R., Bayley, M., Waller, S. and Berridge, V. 2013. Partnerships: survey respondents' perceptions of inter-professional collaboration to address alcohol-related harms in England. Critical Public Health. 23 (1), pp. 62-76. https://doi.org/10.1080/09581596.2012.724770
Partnerships: a mechanism for local alcohol policy implementation.
Thom, B., Herring, R., Bayley, M., Waller, S. and Berridge, V. 2012. Partnerships: a mechanism for local alcohol policy implementation. London Alcohol Research UK.
Reconceptualising harm reduction in prisons
Duke, K. 2011. Reconceptualising harm reduction in prisons. in: Fraser, S. and Moore, D. (ed.) The drug effect: health, crime and society Cambridge, UK Cambridge University Press. pp. 209-224
Alcohol harm reduction in Europe.
Herring, R., Thom, B., Beccaria, F., Kolind, T. and Moskalewicz, J. 2010. Alcohol harm reduction in Europe. in: Rhodes, T. and Hedrich, D. (ed.) Harm reduction: evidence, impacts and challenges. Lisbon, Spain European Monitoring Centre for Drugs and Drug Addiction.
Clashes in culture? the 'professionalisation' and 'criminalisation' of the drugs workforce
Duke, K. 2010. Clashes in culture? the 'professionalisation' and 'criminalisation' of the drugs workforce. British Journal of Community Justice. 8 (2), pp. 31-43.
Growing up with risk
Thom, B., Sales, R. and Pearce, J. 2007. Growing up with risk. Policy Press.
The role of home carers: findings from a study of alcohol and older people.
Herring, R. and Thom, B. 1998. The role of home carers: findings from a study of alcohol and older people. Health Care in Later Life. 3 (3), pp. 199-211.
The right to take risks: alcohol and older people
Herring, R. and Thom, B. 1997. The right to take risks: alcohol and older people. Social Policy and Administration. 31 (3), pp. 233-246. https://doi.org/10.1111/1467-9515.00053
Alcohol misuse in older people: the role of home carers
Herring, R. and Thom, B. 1997. Alcohol misuse in older people: the role of home carers. Health and Social Care in the Community. 5 (4), pp. 235-245. https://doi.org/10.1111/j.1365-2524.1997.tb00119.x
Alcohol-related attendances in the A&E department: could nurses have a preventative role?
Herring, R. and Thom, B. 1999. Alcohol-related attendances in the A&E department: could nurses have a preventative role? Nursing Times. 95 (9), pp. 59-62.
Resisting the gaze? nurse perceptions of the role of accident and emergency departments in responding to alcohol-related attendances.
Herring, R. and Thom, B. 1999. Resisting the gaze? nurse perceptions of the role of accident and emergency departments in responding to alcohol-related attendances. Critical Public Health. 9 (2), pp. 135-148. https://doi.org/10.1080/09581599908402926
Identifying alcohol-related harm in young drinkers: the role of accident and emergency departments
Thom, B., Herring, R. and Judd, A. 1999. Identifying alcohol-related harm in young drinkers: the role of accident and emergency departments. Alcohol and Alcoholism. 34 (6), pp. 910-915. https://doi.org/10.1093/alcalc/34.6.910
Exploring changes in young men's drinking using the AUDIT questionnaire
Harnett, R., Herring, R., Thom, B. and Kelly, M. 1999. Exploring changes in young men's drinking using the AUDIT questionnaire. Alcohol and Alcoholism. 34 (5), pp. 672-677. https://doi.org/10.1093/alcalc/34.5.672
Alcohol in transition: towards a model of young men's drinking styles.
Harnett, R., Thom, B., Herring, R. and Kelly, M. 2000. Alcohol in transition: towards a model of young men's drinking styles. Journal of Youth Studies. 3 (1), pp. 61-77. https://doi.org/10.1080/136762600113040
The Licensing Act 2003: a step in the right direction?
Foster, J., Herring, R., Waller, S. and Thom, B. 2009. The Licensing Act 2003: a step in the right direction? Journal of Substance Use. 14 (2), pp. 113-123. https://doi.org/10.1080/14659890802654532
Local responses to the Alcohol Licensing Act 2003: the case of Greater London.
Herring, R., Thom, B., Foster, J., Franey, C. and Salazar, C. 2008. Local responses to the Alcohol Licensing Act 2003: the case of Greater London. Drugs: Education, Prevention, and Policy. 15 (3), pp. 251-265. https://doi.org/10.1080/09687630801920641
Binge drinking today: learning lessons from the past
Herring, R., Berridge, V. and Thom, B. 2008. Binge drinking today: learning lessons from the past. Drugs: Education, Prevention, and Policy. 15 (5), pp. 475-486. https://doi.org/10.1080/09687630801937355
Binge drinking: an exploration of a confused concept
Herring, R., Berridge, V. and Thom, B. 2008. Binge drinking: an exploration of a confused concept. Journal of Epidemiology and Community Health. 62 (6), pp. 476-479. https://doi.org/10.1136/jech.2006.056721
Black and minority ethnic groups and alcohol: A scoping and consultation study
Thom, B., Lloyd, C., Hurcombe, R., Bayley, M., Stone, K., Thickett, A. and Watts, B. 2010. Black and minority ethnic groups and alcohol: A scoping and consultation study. London Department of Health.
Working with communities: a feature of multi-component programmes to tackle alcohol and drug-related harm
Thom, B. 2009. Working with communities: a feature of multi-component programmes to tackle alcohol and drug-related harm. Socialno Delo. 48 (5-6), pp. 315-325.
Drugs: the great Cannabis debate
Woolner, C. and Thom, B. 2003. Drugs: the great Cannabis debate. in: Matthews, R. and Young, J. (ed.) The new politics of crime and punishment Willan Publishing.
The focus on crime and coercion in UK drugs policy
Duke, K. 2009. The focus on crime and coercion in UK drugs policy. in: MacGregor, S. (ed.) Responding to drugs misuse: research and policy priorities in health and social care London Routledge. pp. 14-24
Evidence-based policy-making?: research utilisation and the development of prison drugs policy.
Duke, K. 2000. Evidence-based policy-making?: research utilisation and the development of prison drugs policy. Social Policy Association Conference. University of Surrey 18 - 20 Jul 2000
Drug consumption in London - A city of diverse and changing scenes
Ward, J. and Thom, B. 2009. Drug consumption in London - A city of diverse and changing scenes. in: Eisenbach-Stangl, I., Moskalewicz, J. and Thom, B. (ed.) Two worlds of drug consumption in late modern societies England Ashgate. pp. 39-56
Binge drinking: a confused concept and its contemporary history
Berridge, V., Herring, R. and Thom, B. 2009. Binge drinking: a confused concept and its contemporary history. Social History of Medicine. 22 (3), pp. 597-607. https://doi.org/10.1093/shm/hkp053
Quantities, quality, costs and sources.
Moskalewicz, J., Ward, J. and Thom, B. 2009. Quantities, quality, costs and sources. in: Eisenbach-Stangl, I., Moskalewicz, J. and Thom, B. (ed.) Two worlds of drug consumption in late modern societies. Ashgate. pp. 247-280
The fast alcohol screening test
Thom, B., Alwyn, T., Hodgson, R. and John, B. 2002. The fast alcohol screening test. Alcohol and Alcoholism. 37 (1), pp. 61-66. https://doi.org/10.1093/alcalc/37.1.61
Self-reported never-drinkers in England 1994-2003: characteristics and trends, focusing on white adults aged 18-54.
Thom, B., Nanchahal, K., Pattenden, S. and Primatesta, P. 2007. Self-reported never-drinkers in England 1994-2003: characteristics and trends, focusing on white adults aged 18-54. Alcohol and Alcoholism. 43 (1), pp. 91-96. https://doi.org/10.1093/alcalc/agm138
From alcoholism treatment to the alcohol harm reduction strategy for England: an overview of alcohol policy from 1950.
Thom, B. 2005. From alcoholism treatment to the alcohol harm reduction strategy for England: an overview of alcohol policy from 1950. American Journal on Addictions. 14 (5), pp. 416-425. https://doi.org/10.1080/10550490500247065
Alcohol, policy and politics in Kazakhstan
Waters, E. and Thom, B. 2007. Alcohol, policy and politics in Kazakhstan. Europe-Asia Studies. 59 (6), pp. 999-1023. https://doi.org/10.1080/09668130701489188
Out of crime and into treatment? The criminalisation of contemporary drug policy since Tackling Drugs Together
Duke, K. 2006. Out of crime and into treatment? The criminalisation of contemporary drug policy since Tackling Drugs Together. Drugs: Education, Prevention, and Policy. 13 (5), pp. 409-415. https://doi.org/10.1080/09687630600613520
Screening for illicit drug use in psychiatric hospitals: whose job is it?
Thom, B., Bloor, R. and Crome, I. 2006. Screening for illicit drug use in psychiatric hospitals: whose job is it? Advances in Psychiatric Treatment. 12 (5), pp. 375-383. https://doi.org/10.1192/apt.12.5.375
Déjà vu?: Opportunities and obstacles in developing alcohol policy in English prisons
Duke, K. 2005. Déjà vu?: Opportunities and obstacles in developing alcohol policy in English prisons. Drugs: Education, Prevention, and Policy. 12 (5), pp. 417-430. https://doi.org/10.1080/09687630500281873
Drugs, prisons and policy-making
Duke, K. 2003. Drugs, prisons and policy-making. London Palgrave Macmillan.
Getting beyond the 'official line': reflections on dilemmas of access, knowledge, and power in researching policy networks
Duke, K. 2002. Getting beyond the 'official line': reflections on dilemmas of access, knowledge, and power in researching policy networks. Journal of Social Policy. 31 (1), pp. 39-59. https://doi.org/10.1017/S0047279402006505
Evidence-based policy making?: The interplay between research and the development of prison drugs policy
Duke, K. 2001. Evidence-based policy making?: The interplay between research and the development of prison drugs policy. Criminal Justice. 1 (3), pp. 277-300. https://doi.org/10.1177/1466802501001003002
Prison drugs policy since 1980: shifting agendas and policy networks
Duke, K. 2000. Prison drugs policy since 1980: shifting agendas and policy networks. Drugs: Education, Prevention, and Policy. 7 (4), pp. 393-408. https://doi.org/10.1080/dep.7.4.393.408
Refugee resettlement in Europe
Duke, K., Sales, R. and Gregory, J. 1999. Refugee resettlement in Europe. in: Bloch, A. and Levy, C. (ed.) Refugees, social policy and citizenship in Europe Palgrave Macmillan. pp. 105-131
The settlement of refugees in Britain
Carey-Wood, J., Duke, K., Karn, V. and Marshall, T. 1995. The settlement of refugees in Britain. London HMSO.