Over one third of prisoners ‘have a drink problem’

The inmates of Winchester Prison have 10 times as many hazardous and dependent drinkers as are found in the general population, and 35 per cent of prisoners believe they have a drinking problem. Nearly half (46 per cent) of prisoners believe that alcohol was linked to their offence, with violent crime accounting for half of these offences.

These are among the conclusions of a new survey of Winchester prisoners conducted by Mike Webb, Alcohol Strategy Co-ordinator of the Hampshire Drug and Alcohol Action Team, and Steve Neville, Winchester Drug Services Team.

Here, MikeWebb gives an account of the survey and its main findings.

Winchester Prison is a category B local prison with an all male population of 697 prisoners who are either on remand, awaiting sentence, serving a short sentence or waiting to be moved to another prison. The majority of prisoners come from across Hampshire and are roughly split from Hampshire, Portsmouth and Southampton.

Winchester Drug Services Team is a multidisciplinary service consisting of prison staff, contracted in-service providers and clinical specialists. Other than the detoxification wing, these services are not funded to work with purely alcohol clients. An alcohol client can only be seen if an illicit drug is also involved. Alcoholics Anonymous go into the prison on a weekly basis.

The prison has a dedicated detoxification landing (34 beds), for both drugs and alcohol. Between April 2005 and March 2006, a total of 222 alcohol detoxifications were carried out, an average of 18.5 a month.

Anecdotal information suggested that the level of alcohol consumption among prisoners at Winchester Prison was unusually high and potentially linked to the crimes that they had committed. The survey provided ample evidence to confirm that this picture is correct.

Prisoners were asked how much alcohol they consumed, and if they felt this to be problematic, in two ways. The first was with a closed question, “Do you have a drinking problem” with the responses “Yes, No, Don’t know” available.The second was by listing different measures of alcohol, such as a pint, and asking how many they consumed within a week. This allowed the unit total to be calculated and compared with the national guidelines for alcohol consumption. These suggest that men should drink no more than 21 units in a week. Moderate to heavy drinking is between 21–50 units a week, while those drinking over 50 units are in the serious/dependant category. The main findings are summarised in graph 1.

The key comparison of this graph is with the hazardous/ dependant drinkers. Winchester Prison has 10 times as many hazardous /dependant drinkers as would be expected to be found in the general population.

The survey also compared the amount of alcohol consumed by prisoners who said that they DID NOT have a drinking problem with those who said that they did have a drinking problem.

The average consumption of the group that said they did not have a drinking problem was 43 units per week, an average that is skewed upwards by a few exceptionally heavy drinkers. 43% are drinking above the recommended limit of 21 units per week. 20% of the respondents who said that they did not have a drinking problem were actually consuming over 50 units per week. This is the level of alcohol consumption that is considered to be serious/dependant and highlights the lack of awareness around safelevels of alcohol consumption within the prison population.

The average alcohol consumption among those who say that they do have a drink problem was a 157 units per week.

Violent Crime
There was a particularly strong relationship between alcohol and violent offences. 22% of all prisoners at HMP Winchester considered that their violent crime offence was related to their alcohol consumption and violent crime accounted for half of all offences from prisoners who reported that alcohol was linked to their criminal activity. Similarly, of those prisoners who believe that they have a drinking problem, over half of the offences are for violent crime. Nearly half of those who said that they would use an alcohol service within the prison were violent offenders.

The question was also asked “How often have you carried out criminal acts while under the influence of alcohol?” The breakdown of responses for violent crime is shown in graph 2, with a comparison given with theft, burglary and other.

When asked if they believed they had a drinking problem, 143 (35%) of respondents believed that they did. Those who had been imprisoned for violent crime are again disproportionately over represented in this finding, as graph 3 illustrates.

Social problems
Respondents identified a range of social problems that they attributed to their drinking behaviour, as outlined in graph 4. Prisoners whose category of arrest was violent and other (of which nearly half are drugs related) are compared with the general prison population.

The three social areas identified where alcohol causes the greatest difficulties for the whole population were:

• Violence to others (156/405)

• Relationship problems (144/405)

• Money problems (128/405)

Within this, those whose category of arrest was violent crime accounted for around half of the violence to other category, social (e.g. housing), medical and injury (to you). The low awareness of medical problems as an issue highlights that prisoners may be unaware of the long term health implications of excessive alcohol consumption.

Domestic violence is the only category that produced an unexpected outcome, with a % that is lower than expected. This may indicate that acknowledging or recognising domestic violence as an issue is difficult.

An interesting follow up exercise would be to carry out a confidential questionnaire with the partners of prisoners to see what they viewed the main social problems caused by alcohol to be.

Service provision
When asked if they would use an alcohol service located within the prison, 198 (49%) of respondents said that they would.

However, from this group of people who have expressed an interest in using a service, 67 (37%) had not used drugs in the previous year and, therefore, might not be eligible to receive a service designed to address their alcohol problem alone.

What the survey shows us
The findings of the survey strongly indicate that:

• Prisoners believe that alcohol is a causative factor in their offending behaviour

• Prisoners believe that alcohol consumption has caused them a number of social problems, principally in relation to violence towards others, relationship difficulties and financial concerns

• Prisoners are drinking at very high levels, with many unaware that they have an alcohol misuse problem

• A high proportion of respondents believe that they have a drinking problem and would like to access an alcohol service if one were available in the prison. However, because a significant proportion (n=67) of these individuals have not taken illicit drugs in the previous 12 months, they may be ineligible for such a service from the Prison Drug Team.

• Prisoners who have stated that their offence is violent crime are proportionately more likely to have identified alcohol as causing them social problems, to have identified alcohol as having been linked with their offending and to be seeking a service to address their drinking. However this over representation of violent offenders may simply be reflective of the mix of prisoners within Winchester.

Where should we go from here?
This data strongly supports the view that there is indeed a significant proportion of the prison population within HMP Winchester who have serious social and offending problems that may be strongly linked to their drinking behaviour; they recognise this problem and have expressed a desire to access services to address it.

The Prison Service Alcohol Strategy for Prisoners and the Treatment Interventions Good Practice Guide provides an alcohol treatment framework but this has not yet been resourced while provision nationally is extremely limited. Given the strong link between alcohol and offending, the potential reduction in re-offending through addressing problem drinking behaviour would indicate that this would be a cost-effective intervention strategy.