Research paper
Cannabis use in a Swiss male prison: Qualitative study exploring detainees’ and staffs’ perspectives

https://doi.org/10.1016/j.drugpo.2013.05.001Get rights and content

Abstract

Background

Several studies suggest a high prevalence of cannabis use before and during imprisonment, but subjective perspectives of detainees and staff towards its use in prison are lacking. This issue was explored in the framework of an observational study addressing tobacco use in three Swiss prisons in 2009 and 2010 that involved multiple strands (quantitative and qualitative components). This article presents qualitative data on cannabis use collected in one of the settings.

Methods

We used in-depth semi-structured interviews with both detainees and staff to explore their attitudes towards cannabis in one post-trial male Swiss prison. We performed specific coding and thematic analysis for cannabis with the support of ATLAS.ti, compared detainees’ and staff's opinions, and considered the results with regard to drug policy in prison in general.

Results

58 participants (31 male offenders, mean age 35 years, and 27 prison staff, mean age 46 years, 33% female) were interviewed.

Detainees estimated the current use of cannabis use to be as high as 80%, and staff 50%. Participants showed similar opinions on effects of cannabis use that were described both at individual and institutional levels: analgesic, calming, self-help to go through the prison experience, relieve stress, facilitate sleep, prevent violence, and social pacifier. They also mentioned negative consequences of cannabis use (sleepiness, decreased perception of danger and social isolation), and dissatisfaction regarding the ongoing ambiguous situation where cannabis is forbidden but detection in the urine was not sanctioned. However, the introduction of a more restrictive regulation induced fear of violence, increased trafficking and a shift to other drug use.

Conclusion

Although illegal, cannabis use is clearly involved in daily life in prison. A clearer and comprehensive policy addressing cannabis is needed, including appropriate measures tailored to individual users. To sustain a calm and safe environment in prison, means other than substance or medication use are required.

Introduction

Worldwide, cannabis is the most frequently used illegal substance: lifetime prevalence varies between less than 1–42% in adults, one-year prevalence among the adult population in Western Europe in 2009 has been estimated to be of 7.1% (Degenhardt et al., 2008, Degenhardt and Hall, 2012) and 6.9% of adults between 15 and 34 years used cannabis in the last month in Europe (EMCDDA, 2010a). Desired effects are mild euphoria, relaxation, increased sociability, sedation, analgesia, appetite and mood enhancement, anti-emetic effects, anxiolytic action and feelings of well-being (Hall and Degenhardt, 2009, Hall and Solowij, 1998). Effects of cannabis vary among subjects due to their individual differences in responding to cannabinoids, the dose, the personal experience, the mood and social setting of the use (Grotenhermen, 2007, Hall and Degenhardt, 2009).

People who use drugs are overrepresented in prison (Butler et al., 2011, Eytan et al., 2010, Fazel et al., 2006, Niveau and Ritter, 2008, WHO, 2007), with reported prevalence of drug users in prisons much higher than among the general population, and cannabis being the most frequently illegal drug used. European studies reported prevalence of cannabis use prior to imprisonment of 65% in the largest remand prison in Switzerland (Niveau & Ritter, 2008); 38% in France (Sahajian, Lamothe, & Fabry, 2006); 50–55% in the UK (Heidari et al., 2007, Stewart, 2009); 74% in Greece (Fotiadou et al., 2004) and 75% in Scotland (SPS, 2011). Data in Australia are comparable with 71% of men having a medium or high risk use (Holmwood, Marriott, & Humeniuk, 2008) and in the US, a 83% lifetime prevalence for cannabis was reported in incoming detainees (Lo & Stephens, 2000).

Although data is sparse, cannabis has also been reported to be the most frequently used illicit drug while in prison (EMCDDA, 2010b, Singleton et al., 2003). In Scotland for example, cannabis use was reported by 64% of the prisoners who reported drug use during the incarceration (one fifth) (SPS, 2011). Still, perceptions, and reasons for use during imprisonment have only rarely been explored worldwide. In previous qualitative researches, detainees have cited reasons for use such as coping with imprisonment and handling its related stress, as well as the calming and anxiolytic effects, along with improvement on sleep and psychological health (Frank and Kolind, 2008, Keene, 1997, Kolind et al., 2010). Staff has reported cannabis as harmless, and emphasised its calming, peace-keeping and happiness-inducing effect on detainees. According to their views, cannabis might also prevent the use of other drugs (Keene, 1997).

In a study using mixed methods (questionnaires, air quality measurements and interviews) to explore the attitudes of detainees and prison employees towards tobacco use in three prisons (2009–2010) in Switzerland, participants spontaneously raised the issue of cannabis in one of the settings. This matter obviously appeared to be of major concern to them. Since prison administrators were planning a change in the cannabis policy, and no study ever addressed specifically this issue in Swiss prisons, we decided to address this topic systematically in more depth during the interviews. The objective was to explore how detainees and staff perceive cannabis use in this particular setting, and to raise evidence on which prison administrators could base their new policy.

This article presents the results of this specific aspect of the study. It describes statements made about the influence of cannabis on individuals and on prison life, and it discusses the possible contribution of these statements to the design of a cannabis policy. Results of other topics of the interviews are published elsewhere (Ritter & Elger, 2013).

Section snippets

Methods

The study took place in a male post-trial detention centre with 120 detainees (main duration of stay 6 months) and 120 employees, one of the three settings of the larger study. Recruitment of participants is described elsewhere (Ritter & Elger, 2013). The cantonal research ethics committee approved the research project.

In this setting detainees work 5 days a week (agricultural production and animal care, cooking, maintenance, building, carpentry, wood working). Various sport activities are

Results

Fifty-eight participants were included: 31 male offenders (mean age 35 years) and 27 prison staff (mean age 46 years, 33% female). Their characteristics were previously described (Ritter & Elger, 2013). We present the results according to the themes of analysis. Detainees’ quotes are indicated with the code (Det), and staff with (Pers).

Discussion

This qualitative study reports attitudes on cannabis in this post trial male detention prison, considering individual and collective aspects, and comparing detainees’ and staff's perceptions. The results showed that both groups of participants estimated that cannabis use was common in that setting: detainees reported 40–80% and staff 50% prevalence. Cannabis was felt to fulfil diverse functions at the physical (analgesic) and psychological levels (help to sleep, calming, stress relieving),

Ethical approval

The cantonal (Bern, Switzerland) research ethic committee approved the research.

Funding

The Tobacco Prevention Fund at the Swiss Federal Office of Public Health (Grant Number 08.002295) provided support to do this research and submit our work for publication. The salary of one research fellow was financed through this way. One of the prerequisite was to publish research data. But the results and analysis of the study are completely independent from the funding source. Only the researchers have access to the data regarding the research (participants data, results).

Competing interests

All authors have no competing interests.

Acknowledgments

We thank the prison administrators and detainees for participating and facilitating the study.
Conflicts of interest statement

I Catherine Ritter the Corresponding Author of the submitted article disclose on the behalf of all authors any actual or potential conflict of interest, including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence the

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