Cost implications of random mandatory drugs tests in prisons

Detection of drugs in Australian prisons: supply reduction strategies

Purpose

– Prisoners have a high level of drug use prior to imprisonment. Many inmates report having injected drugs and using cannabis. Prison authorities employed a range of strategies to detect drugs and drug use in prison. However, it was unclear which supply reduction strategies operated, and the prevalence and types of drugs detected in Australian prisons. The purpose of this paper is to examine supply reduction strategies in Australian prisons. Information on searches for drugs, and from inmate urinalysis was collected. The study focussed on adults in fulltime custody in Australia in 2009.

Design/methodology/approach

– A representative of all corrective services departments and justice health services was asked to complete a questionnaire on supply reduction strategies, including searches for drugs and drug testing of inmates.

Findings

– The two main supply reduction strategies identified in all Australian prisons were the use of drug detection dogs and urinalysis programs. Despite an extensive use of drug searches and urinalysis, the detection of drugs was modest for both strategies. The most commonly used drug was cannabis with the detection of drugs such as amphetamines and heroin being very low.

Research limitations/implications

– Prison inmates have a history of high levels of drug use prior to imprisonment. However, the supply reduction measures of drug detection dogs and urinalysis indicate that drug use was low in Australian prisons.

Practical implications

– The paper recommends that urinalysis comprises targeting testing regimes and that random testing ceases in order to be a more cost effective use of resources for drug detection.

Originality/value

– The study is the first report on the range of supply reduction measures in Australian prisons and, possibly in the world. Both measures were employed extensively across the country and finds of drugs and drug use were relatively low. Two possible conclusions can be drawn; that either drug use was very low in prison or that it was well concealed from the authorities. A comparison of random testing with targeted testing of inmates, where the former yields fewer positive results shows drug use was likely to be low rather than well concealed.

Comparisons of self-report data and oral fluid testing in detecting drug use amongst new treatment clients

Drug testing is widely used and employed in diverse contexts, including drug treatment clinics. Building on previous research, this paper aims to (i) compare self-report data and oral fluid (OMT) testing in detecting drug use amongst individuals beginning a new episode of drug treatment and (ii) identify factors that may predict drug users who have discordant self-report and OMT test results. Two hundred and seventy-one new drug treatment clients completed a structured questionnaire that included questions relating to drug use during the preceding 3 days and provided an oral fluid sample that was independently tested for opiates, benzodiazepines, methadone and cannabis. Data were analysed using kappa statistics (Cohen, 1960) and univariate and multivariate logistic regression. Findings indicated a high level of consistency between self-reported drug use and OMT testing. However, agreement varied by drug type and respondents commonly reported consumption that screening failed to identify. Inconsistencies appeared to relate to a number of factors and were not necessarily a function of deliberate distortion by the drug user. Overall, it is concluded that OMT testing is a good indicator of the validity and reliability of drug users' self-report data. Nonetheless, its accuracy might be greater for some drug categories than for others. Equally, further study comparing test results and self-reported drug use amongst different populations and in different contexts is required.

Infant leukemia suggestive of natural killer cell precursor origin followed an unusual clinical course

We report a patient with infant leukemia showing the rare phenotypes of CD2+, CD4+, CD7+, CD56+, CD3-, CD5- who followed an unusual clinical course. The patient was a 3-month-old girl who was admitted because of unusual purpura looking like a black ring. On admission WBC count was 85.8 x 10(9)/l and bone marrow aspiration revealed a nucleated cell count of 112.0 x 10(9)/l with 70.8% atypical lymphocytes. On the 3rd hospital day, the WBC count decreased by about 1/5 without chemotherapy and partial remission was obtained. But about 3 weeks later, the WBC count increased again and she died. Based on surface marker analysis, genotypic analysis and autopsy, we diagnosed infant leukemia suggestive of natural killer (NK) cell precursor origin.