Does drug testing in prisons reduce drug use?

Australian researchers are questioning the need for mandatory drug testing in prisons.

Nearly 2 in 5 people report using illicit drugs in Australian prisons, including 14% who reported use of injected drugs.

Every Australian state and territory uses some form of compulsory testing, usually with urine tests, to try and manage it.

But researchers say there’s no indication that this testing helps.

“There’s a lack of evidence that it deters drug use,” says Dr Jocelyn Chan, an epidemiologist at the Burnet Institute and lead author on a recent commentary in Drug and Alcohol Review.

In fact, says Chan, there is evidence that mandatory testing can cause more problems.

“There’s pretty strong evidence that this punitive approach can cause harm, and it also deters people from seeking treatment,” she tells Cosmos.

This is because the tests can be invasive, and punishments for testing positive can make rehabilitation harder. In their commentary, the researchers also suggest there’s a risk that people seek out more dangerous but less detectable drugs in response to testing regimes, such as switching from cannabis to opioids.

“A lot of the things that we do, including incarcerating people and then trying to enforce this abstinence, is often not evidence-based and can cause harm,” says Chan.

“There is evidence for what does work, and it’s probably better to focus on that. For example, there’s a lot of evidence for opioid agonist treatment for people in prison to treat heroin addiction, and that can reduce drug use in prison and reduce risk of overdose when people leave prison, which is a really high-risk period.”

The researchers point out that methods other than urine testing can help monitor drug use.

“Surveillance is a really important part of public health. It helps us understand the scope of the problem and monitor how well our programs are working,” says Chan.

“The best way to find out about drug use in prison is just ask people in prison, and when you don’t punish them when they tell you, then you’re more likely to get a true response.

“If you’re looking for objective measures of drug use in prisons, then people have done wastewater surveillance, which provides a really good indication.”

Chan says harm reduction policies can improve the health of people more effectively than punitive responses.

“Sometimes, when you focus on drug use alone, you can actually create more harm,” she says.

“This harm reduction response, is about meeting people where they are, and rather than focusing on the drug use itself, it’s focusing on the harms that using drugs can bring.”