Last week, Public Health England published a new report on substance misuse services in prisons, which reported that 35% of people starting treatment in prison substance misuse services between 2018 and 2019 are either currently injecting (19%) or have done so in the past (16%). Worryingly, it also found that the number of people who died while on treatment in 2018 to 2019 was 26% more than the previous year (43 to 54).
People in prison are an at-risk group for hepatitis C according to the National Institute of Clinical Excellence (NICE); the virus affects as many as one in 10 people in prison. Substance misuse services in prisons are crucial points of engagement for people who may have hepatitis C, given that around 90% of new infections occur through injecting drug use. The controlled prison environment can provide a unique opportunity to engage people in treatment services for long enough to clear their hepatitis C. Substance misuse services also have the potential to be important sources of information to encourage safer injecting practices and prevent reinfection. Disappointingly, the report makes no mention of blood-borne virus testing or harm reduction measures.
Educating people about how to minimise their risk of infection while taking drugs is especially important given the findings of the report that 35% of the people starting treatment in prison substance misuse services between 2018 and 2019 were either currently injecting or had done so in the past.
Our work in prisons uses the shared experience and identification between people in prison and our peers in order to encourage people to get tested and treated for hepatitis C. We have worked in substance misuse services to deliver peer-to-peer workshops, awareness training, and one-to-one interventions to over 5,200 people in prison. We have also delivered key information about hepatitis C, hepatitis B and HIV to over 1,200 prison staff members.