Prescription of pain medication in prisons: A comparative analysis of younger and older male prisoners

Annaheim, Beatrice; Handtke, Violet; Belardi, Angelo; Elger, Bernice Simone

doi:10.1002/pds.4573

Cited by 6 publications

(6 citation statements)

References 39 publications

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“…Chlordiazepoxide is recommended for uncomplicated alcohol withdrawal as it has a low dependence-forming potential [ 22 , 43 ], whereas diazepam is recommended if there is a history of concurrent benzodiazepine dependence [ 22 ]. Opioid prescriptions in prisons were almost entirely limited to tramadol, similar to findings from a study in Swiss prisons [ 44 ]. A repeated cross-sectional analysis of the national community pharmacy claims database in Ireland between 2010 and 2019 also identified tramadol as the most frequently prescribed product, however oxycodone and tapentadol prescribing were increasing over the study period [ 40 ].…”

Section: Discussionsupporting

confidence: 80%

Prescription drugs with potential for misuse in Irish prisons: analysis of national prison prescribing trends, by gender and history of opioid use disorder, 2012 to 2020

Durand,

Keenan,

O’Reilly

et al. 2023

BMC Psychiatry

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Background Pharmacotherapy is essential for the delivery of an equivalent standard of care in prison. Prescribing can be challenging due to the complex health needs of prisoners and the risk of misuse of prescription drugs. This study examines prescribing trends for drugs with potential for misuse (opioids, benzodiazepines, Z-drugs, and gabapentinoids) in Irish prisons and whether trends vary by gender and history of opioid use disorder (OUD). Methods A repeated cross-sectional study between 2012 and 2020 using electronic prescribing records from the Irish Prison Services, covering all prisons in the Republic of Ireland was carried out. Prescribing rates per 1,000 prison population were calculated. Negative binomial (presenting adjusted rate ratios (ARR) per year and 95% confidence intervals) and joinpoint regressions were used to estimate time trends adjusting for gender, and for gender specific analyses of prescribing trends over time by history of OUD. Results A total of 10,371 individuals were prescribed opioid agonist treatment (OAT), opioids, benzodiazepines, Z-drugs or gabapentinoids during study period. History of OUD was higher in women, with a median rate of 597 per 1,000 female prisoners, compared to 161 per 1,000 male prisoners. Prescribing time trends, adjusted for gender, showed prescribing rates decreased over time for prescription opioids (ARR 0.82, 95% CI 0.80–0.85), benzodiazepines (ARR 0.99, 95% CI 0.98–0.999), Z-drugs (ARR 0.90, 95% CI 0.88–0.92), but increased for gabapentinoids (ARR 1.07, 95% CI 1.05–1.08). However, prescribing rates declined for each drug class between 2019 and 2020. Women were significantly more likely to be prescribed benzodiazepines, Z-drugs and gabapentinoids relative to men. Gender-specific analyses found that men with OUD, relative to men without, were more likely to be prescribed benzodiazepines (ARR 1.49, 95% CI 1.41–1.58), Z-drugs (ARR 10.09, 95% CI 9.0-11.31), gabapentinoids (ARR 2.81, 95% CI 2.66–2.97). For women, history of OUD was associated with reduced gabapentinoid prescribing (ARR 0.33, 95% CI 0.28–0.39). Conclusions While the observed reductions in prescription opioid, benzodiazepine and Z-drug prescribing is consistent with guidance for safe prescribing in prisons, the increase in gabapentinoid (primarily pregabalin) prescribing and the high level of prescribing to women is concerning. Our findings suggest targeted interventions may be needed to address prescribing in women, and men with a history of OUD.

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Section: Discussionsupporting

confidence: 80%

Prescription drugs with potential for misuse in Irish prisons: analysis of national prison prescribing trends, by gender and history of opioid use disorder, 2012 to 2020

Durand,

Keenan,

O’Reilly

et al. 2023

BMC Psychiatry

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“…(Bor, 2022: 622) Research in gerontology shows that the generic pains of imprisonment for ageing individuals are exacerbated in prison, which is an environment deeply masculine and designed for aggressive young men. As such, older men do 'harder time' and experience imprisonment as a more severe form of punishment than their younger counterparts (Annaheim et al 2018;Mann, 2012). Much like their counterparts in the community, aging prisoners frequently reported problems associated with activities of daily living such as walking long distances, moving up to the top bunk, standing for long periods, keeping pace with others, ascending and descending stairs, and hearing or seeing (Aday, 2001;Humblet 2021).…”

Section: The Pains Of Life Imprisonment Through the Prism Of Old Agementioning

confidence: 99%

‘Time's relentless melt’: The severity of life imprisonment through the prism of old age

Vannier

Nellis

2023

Punishment & Society

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This paper considers the pains of life-sentence imprisonment through the novel vantage point of old age understood as a process. Our prison populations are getting older and the use of life sentences is dramatically increasing. Yet, research, campaigning, law and policy have not addressed the long-term consequences of imposing life sentences on prisoners who will age. Whilst far from exhaustive, our study draws on studies in gerontology, health policy and penology. We rely on shared analysis of collected official data from the US and the UK to highlight how the expansion and growth of life sentences on the one hand, and the dramatic aging of the prison population, on the other, are intertwined and need to be considered together. This article emphasizes the urgency of taking a holistic approach to penal severity, one that includes analyses of scale, lived experiences, as well as of law and politics, to uncover the multiple forms of marginalization elderly prisoners are exposed to. Aging is a phenomenon we will all experience, yet, in the context of imprisonment, we argue that old age is a ‘prison problem’ rather than a ‘prisoner problem,’, urging research and policy to depart from the conventional and reductive view of the older prisoner as one in need of transformation and treatment or as being inherently criminal.

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“…Many studies elaborated on the prison system’s inability to provide OPs with their required health care, and highlighted experiences of mishandled pain and illness (Iftene, 2017). Thus, the overall impression from the body of research concerning ageing in prison is that most OPs suffer far more than their younger peers from the consequences of incarceration (Annaheim et al, 2018; Scaggs, 2017; Wangmo et al, 2016).…”

Section: Perspectives On Ageing In Prison: Challenges Hardships and Painmentioning

confidence: 99%

‘A sense of purpose’: Older prisoners’ experiences of successful ageing behind bars

Avieli

2021

European Journal of Criminology

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There is growing interest in ageing offenders and their lives in prison. However, this subject is often studied from a deprivation perspective, focusing on issues such as lack of medical care and proper environmental conditions. This article highlights experiences of wellbeing while ageing in confinement, using the conceptual framework of successful ageing. An interpretive phenomenological analysis perspective was used to analyse the narratives of 18 older prisoners. The narratives revealed four themes: ‘Like all other older men’: comparing ageing in prison with ageing within the community; ‘Better than what I have outside’: prison as an escape from a life of loneliness, poverty and delinquency; ‘Here I get some respect’: the older prisoner as a mentor; and ‘I feel accomplished’: experiences of growth and self-discovery as a means for successful ageing in prison. The findings suggest that ageing in prison may not be perceived as a single, unified process, but as a personal and individual phenomenon, and that old age may facilitate positive changes in the lives of ageing offenders in prison.

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Prescription of pain medication in prisons: A comparative analysis of younger and older male prisoners

Cited by 6 publications

References 39 publications

Prescription drugs with potential for misuse in Irish prisons: analysis of national prison prescribing trends, by gender and history of opioid use disorder, 2012 to 2020

Prescription drugs with potential for misuse in Irish prisons: analysis of national prison prescribing trends, by gender and history of opioid use disorder, 2012 to 2020

‘Time's relentless melt’: The severity of life imprisonment through the prism of old age

‘A sense of purpose’: Older prisoners’ experiences of successful ageing behind bars

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