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4. ADDICTIONS
Management and Policy
4.1 The addiction policy lacks direction. There is no strategic drugs meeting and consequently no overall management or co-ordination of the addiction services. Drug issues are discussed at the rehabilitation and care group. Staff feel that they are in 'fire fighting' mode. The drugs issue is not being dealt with effectively. It is recommended that an Addiction Strategy Group, chaired by a senior manager, is set up.
4.2 An addiction team meets once a week. This is attended by the doctor, the addiction nurse, the Phoenix House manager, an addictions officer and a social worker when available. This meeting discusses individual cases and seems to work well with shared decisions being made about prisoners with complex addiction problems.
4.3 The nature of the addiction service provided is changing. Officers previously designated as drug support staff are being redeployed to other duties and the last of three officers still in post was soon to be transferred. The services provided by these officers will be provided by Phoenix House staff and the additional addiction nurses.
Phoenix House
4.4 Phoenix House has now taken over the casework contract from Cranstoun Addiction Services, and was beginning to implement the new enhanced casework process. Staffing includes a manager and three caseworkers. There were two posts vacant which Phoenix were advertising for at the time of inspection. Phoenix offers harm reduction intervention, assessment and case work, smoking cessation, and alcohol awareness.
4.5 Referrals to Phoenix have dropped recently. This may be partly due to short-term prisoners, who previously would have remained at Perth, being transferred elsewhere while building work was ongoing. Additionally, very few referrals come from the Core Screen Assessment during induction. This process does not seem to be working well in Perth.
Nursing
4.6 The addictions nurse provides a service three to four days a week, with the remaining days allocated to the Open Estate. The nurse has a caseload of 60, including Friarton, and a waiting list of around 30. The nurse administers methadone and detoxification medication but is not able to support prisoners after detoxification or support those on methadone. The addiction nurse also does urine testing, although only infrequently due to the workload. The urine testing process is such that it may well be possible for prisoners to present samples of urine that are not their own. This should be addressed.
Mandatory Drug Testing
4.7 MDT staffing was reduced from three to two in February following the SPS decision to stop Random Mandatory Drug Testing. This was then reintroduced by SPS during the year, and in September 46 people were selected for testing in Perth: 20 refused and seven tested positive.
4.8 There has been no frequency testing in the last year. This is surprising as this type of testing can be used to help prisoners who want to address their problem.
Links with the Community
4.9 The prison has very good links with the community, particularly the Tayside Drug Service and the Tayside Resettlement Team. Senior staff are involved in two local Drug Action Teams.
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