Drug Addiction and HIV in Prisons: Treatment and Prevention
Treatment for Special Needs Groups in Prisons
Drug Addiction and AIDS
In penal institutions, the likelihood of HIV transmission increases, especially for patients with contact with the external environment, raising the possibility of contagion to the general population. The Prison Rules provide for the inclusion of internal programs and opiate substitution treatment. Yet, not providing syringes is still widely practiced, only at the request of anyone asking. It has also become necessary to extend the recommendations relating to:
- The prevention of HIV transmission among injecting drug users: The objective is to reduce or eliminate needle sharing.
- Criteria that should govern the detection of serological markers of infection by HIV: Refers to the completion of the test subject to the same criteria that is submitted to the rest of the population:
- Doctor-patient relationship subject to rules of professional conduct and medical ethics.
- Patient consent, who signs the document.
- Confidentiality.
- Counseling and health education before and after the completion of the test.
Besides prevention, penal institutions must carry out the treatment of people affected by HIV and drug addiction. Specialized treatment centers have not yet reached a sufficient number of cases. A Multisectoral Plan of Action for AIDS prevention and care remains in the penal institutions. It aims for the following purposes:
- Expanding internal exposure to prevention programs for parenteral transmission.
- Intensifying awareness and surveillance.
- Extending the availability of sterile injecting equipment.
- Promoting the adoption and maintenance of safer sex.
- Integrating HIV prevention activities with those aimed at addressing health problems.
The Prison Rules provide for the release of terminally ill people, also recognized in the new penal code, requiring the existence of a social report that ensures social and familial support outside the prison and, in their absence, stating the commitment of admission to any institution or association.
Action Against Drug Abuse
Prevention, Care, and Alternatives to Addiction
1. Supporting the freedom of people. The problem of drug addiction affects both the individual, their family, and society as a whole. At present, consumption patterns have changed. Various plans and actions have been launched since the mid-1980s. The principles that have been gaining the lead include prevention, assistance, and social integration as central measures. Coordination of actions between all levels of government is essential, as is the design of bodies to carry out public policies related to the topic.
2. New Patterns of Consumption and Substance Abuse. Adapting the welfare system’s response to emerging needs. In Spain, there has been a drug crisis defined by four processes:
- The rapid expansion of high-intensity forms of certain drugs.
- The generation of an alarm for such consumption and its consequences.
- The growth of a new informal economy more or less dedicated to the production and distribution of drugs.
- The development of a public health problem that results from damage to health.
Changes in Consumption Patterns and Addictive Substances
Between 1977 and 1992, there was a heroin crisis. The number of users decreased, and mortality increased, highlighting the change of administration route to avoid the risk of being affected by HIV/AIDS. Synthetic drugs appeared, which stimulate the central nervous system and have strong social relations. Another major change is the consumption of alcohol among an increasingly younger population.
Consumption of synthetic drugs and alcohol match a number of features:
- They are young standard.
- Consumption focuses on space and time for fun.
- The substances are key in the relational world.
- There is little risk awareness.
Also detected is a decrease in the age of snuff consumption and increased consumption among women.