1. European Questionnaire on Drug Use among Prisoners - EQDP
V. Mravčík, L. Carapinha, K.Grohmannová,
F. Nava, J. Sieroslawski, F. Tognazzo,
A. Torres, I. Kvaternik, D. Hedrich, L. Royuela, L. Montanari

2. Rationale for EQDP
To introduce a standard for cross-sectional questionnaire surveys on drug use (and related factors) among prisoners
Compatible with other EMCDDA standards: General Population Surveys, Treatment Demand indicators
Public health perspective: to improve physical, psychological and social conditions and availability/accessibility of services in prisons
In line with scientific and ethical standards, NOT focused on the principle of control

3. The main sections of EQDP
General information
Drug use outside and inside prison
Drug injecting and other health risk behaviours
Health status
Use of health and drug services
Accompanied by Methodological Specifications (principles and guidelines)

4. Process
: methodological framework assessment report on ~50 national forms working group meetings 2014: draft questionnaire : EQDP pilot exercise 2016: EMCDDA project coordinated by Czech Experts analysing data from pilot exercise 2 working group meetings April/November re-drafting the EQDP 2017: finalisation, editing

5. 2016 pilot data collection and analysis
5 countries: Czech Republic, Italy, Poland, Portugal and Slovenia
Aggregated data
Age-group 15-34, both genders
All cross-sectional
Anonymous
Year of data collection:
Differences in coherence with EQDP
Differences in design and methods

6. Differences in design and methods
Sampling: random – purposive – convenience
Sample size: min. 40, max. 2149
Coverage: one prison – national
Data collection: self-administered – F2F
Differences in substances included / operationalised: (meth)amphetamines, crack cocaine, sedatives, NPSs...

7. Variables used for pilot analysis
Lifetime prevalence (LTP), last-year prevalence (LYP) and last-month prevalence (LMP) before current imprisonment = LTP, LYP, LMP
LTP during any imprisonment
Injecting:
lifetime
during 30 days before current imprisonment
lifetime during any imprisonment (PL: ever injecting during current imprisonment, IT: injecting during current imprisonment)
Comparison with prevalence rates from general population surveys (EMCDDA standard tables)

8. Examples of results: LTP before current imprisonment – males (%)
Notes: Number of valid answers in individual substances is in Poland , in Portugal , in Czech Republic , in Italy 40, in Slovenia

9. Examples of results: LTP during any imprisonment – males (%)
Note: Number of valid answers in individual substances is in Poland , in Portugal , in Czech Republic , in Italy 40, in Slovenia

10. Examples of results: Injecting drug use (%)
Notes: * Poland: ever injecting during current imprisonment, Italy: injecting during current imprisonment. Number of valid answers is in males in Poland , in Portugal , in Czech Republic , in Italy 40, in Slovenia ; in females in Portugal 59, in Czech Republic 45.

11. Two index indicators constructed
LTP in prison/LTP before current imprisonment (both from prison population):
reduction of drug use in prison(s) as compared with drug use in a lifetime of prisoner(value of 1 indicates no decrease; value of 0.5 indicates decrease by 50 %).
LTP before (prison population)/LTP (general population):
an excess of drug use in prison population as compared with general population of the same age (15-34) and gender (for example value of 10 indicates 10-fold excess).
Note: In comparison of prevalence between prison population and general population in females (available just for Portugal and the Czech Rep.), rates in some drugs in GPS were 0.0. I order to allow comparison with prison population, these “zero” prevalence rates were transformed into 0.5 %. So as a consequence in those cases, an indicator (index) comparing prison and general population might be underestimated.

12. LTP during imprisonment versus LTP before current imprisonment

13. LTP during imprisonment versus LTP before current imprisonment

14. Comparison of drug use in prison population with general population: LTP

15. Comparison of drug use in prison population with general population: LYP

16. Summary
Differences in drug use prevalence between countries (situation in general population reflected in prison population)
Excess of prevalence of drug use in prison population as compared with general population
highest excess in heroin, cocaine/crack and (meth)amphetamine
higher excess among females
Reduction of drug use in prisons
lowest reduction in tobacco and medicines (sedatives and hypnotics)
higher reduction among females
Data not fully comparable (methodology, variables) – standardisation (EQDP) needed

17. Thank you for your attention!

18. Annexes (not to be presented)

19. Survey design and methods
Poland
Portugal
Czech Republic
Italy
Slovenia
Aims of the study
Pilot study of EQDP
To map substance use, risky behaviour, but also living conditions in prisons, interventions in prisons, concerns
To map substance use, risky behaviour, experience with drug services and interventions available in prisons
To map substance use
Method (design)
Pilot cross-sectional study
Repeated cross-sectional study
Cross-sectional study (1st ever)
Year of data
2014
2015/2016
2015
Age and gender
17+, males
16+, both gender
15+, both gender
18+, males
19+, males, females (but data provided just for males)
Target population
6 selected prisons.
Excluded individuals in high security regime and remand prison population (restricted regime) Included people under administrative arrest.
All 47 prisons. Excluded 1 special prison for imprisonment of law enforcement staff. Included juvenile prisoners aged 16-18
All 35 prisons. All prisoners serving a prison sentence (females, males, young offenders). Excluded remand prisons.
2 prisons.
Persons treated in prisons for addiction (drug, alcohol, gambling).
Sentenced or arrested for an administrative offence
Prisoner serving a prison sentence, all prisons in a country except prison for juveniles.
Sampling
Purposive sampling, combination of various types of units/prisons.
Stratified random sampling.
Simple random sampling.
Convenience sampling.
Self-nomination (?)

20. Survey design and methods (2)
Poland
Portugal
Czech Republic
Italy
Slovenia
Nett sample size
296
2149
1751 40
688
Data collection mode
Self-administered in a group setting with research assistant; questionnaires inserted into envelops
Self-administered in a group setting with research assistant; questionnaires inserted into envelops;
box for completed questionnaires.
Without the presence of prison guards. Distribution of the leaflets to the prisoners, chronological steps (distributed during breakfast, info on the study and its aims) Meetings with directors and intermediate stuff
Self-administered in a group setting with research assistant; questionnaires inserted into envelops; box for completed questionnaires.
With presence of a prison guard. Some individuals excluded for security reasons (just single cases).
F2F interviews with selected prisoners (20 from community regime and 20 normal regime).
Anonymity
Anonymous, no data per prison
Not anonymous, but confidential (treatment setting)

21. Substances Substances (I-included, x-not included) Poland Portugal
Czech R.
Italy
Slovenia
Tobacco I
I (NOT in prison)
I (JUST in prison)
Alcohol
Cannabis
Powder cocaine HCl
Crack cocaine x
Amphetamine(s)
Methamphetamine
Ecstasy
Hallucinogenic mushrooms
Ketamine
LSD
Heroin
Methadone misused
Buprenorphine misused
Fentanyl illicit/misused
Other opioids (specify), in PL so-called kompot
Barbiturates misused
Benzodiazepines misused
GHB/GBL
Hypnotics/sedatives
Volatile inhalants/solvents
NPS
Anabolic steroids

22. Drug categories in prison surveys and GPS
Tobacco
Alcohol
Cannabis
Powder cocaine HCl
Cocaine (total, including crack)
Amphetamine(s)
Amphetamines
Methamphetamine
Ecstasy
Hallucinogenic mushrooms
Other hallucinogens (hallucinogenic mushrooms, in Italy plus ketamine)
LSD
Heroin
Barbiturates misused
Sedatives and/or tranquillisers
Benzodiazepines misused
Hypnotics/sedatives
Volatile inhalants/solvents
Solvents or inhalants
NPS
Other 1 (available in Portugal , Czech Rep., Slovenia)
In Portugal: legal highs (e.g. salvia, spice, mephedrone, etc.)
In Czech: New psychoactive substances - including other synthetic and/or herbal drugs=substances with stimulating, hallucinogenic or sedative effects that imitate known illicit drugs.
In Slovenia: new drugs (like Spice, Mefedron, Metilon, etc).
Anabolic steroids