Global initiative on Accessible, Comprehensive and Quality Treatment for People with Drug Use Disorders and Associated Mental Health Disorders in Prison Settings

A solid majority of countries worldwide are still operating with overcrowded prisons and often even above 150% of the prison capacity. Currently, there are 11.2 million people in prisons globally . According to the World Drug Report 2017, drug use is higher in prison settings compared to the general population. High use of synthetic drugs such as synthetic cannabinoids, synthetic opioids, synthetic cathinones and new benzodiazepines have been reported in prison settings.  
The work of UNODC on mental health and drug use disorder treatment in prison settings responds to resolution 61/7  on the Commission on Narcotic Drugs on “addressing  drug problem” and the 2016 United Nations General Assembly Special Session on Drugs (UNGASS) Outcome Document , which suggests to “promote and strengthen regional and international cooperation in developing and implementing treatment-related initiatives (…), enhance technical  assistance and capacity-building and ensure non-discriminatory access to a broad range of interventions, including psychosocial, behavioural and medication-assisted treatment, as appropriate and in accordance with national legislation, as well as to rehabilitation, social reintegration and recovery-support programmes, including access to such services in prisons and after imprisonment(…)”.  
UNODC is the custodian of the United Nations Standards Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), which highlight the need to provide “health-care service for the psychiatric treatment of all other prisoners who are in need of such treatment” and in many places highlights the needs for equitable access to health care, including mental health services and services for the treatment of drug use disorders. 

As generally, access to health care services for people in prisons are limited globally, evidence-based treatment and care for people with drug use disorders in prison settings are even more so important. The importance of the provision of treatment of drug use disorders in prison settings as well as the integrated treatment of drug use disorders and related mental health disorders has furthermore been described in the UNODC/WHO International Standards for the Treatment of Drug Use Disorders.The global initiative is aiming to be implemented in all regions and UNODC stands ready to support countries in their efforts to strengthen quality and accessibility of drug use disorder treatment and care services for people with drug use and associated mental health disorders in prison settings. The overall objectives include to:

• Development of updated technical guidance and training materials (including online training) on accessible, evidence-based, comprehensive and quality treatment of drug use disorders for people with drug use and associated mental health disorders in prison settings for UN Member States and other stakeholders, including options for post-sentencing alternatives to incarceration and prison release 
• Development, field-testing and dissemination of newly developed tool in this field 
  • Build communities of practice and networks of countries and service providers across countries for mutual support and to share good practices and lessons learnt on treatment services and care for people with drug use and associated mental health disorders in prison settings: Development of a mentoring network on effective treatment of drug use disorders in prison settings and upon release from prison 
• Enhance the capacity and coordination of health, law enforcement, legal and social actors and their respective institutions 
• Continue global advocacy with UN Member States and civil society on the need for increased access to treatment of drug use disorders and other mental health disorders in prison settings