The Costs Of Tackling Drug Harms In Prisons

By the U.K. Ministry of Justice and Department of Health & Social Care

1 In April 2025, approximately 40,000 people in prisons in England and Wales (50%) had an identified drug problem. Misuse of illicit drugs by people in prison creates or exacerbates risks to their health, well-being and personal safety. Between December 2022 and December 2024, the Prisons and Probation Ombudsman investigated 833 deaths, of which 136 (16%) were drug-related. Conveyance, supply and use of illicit drugs also increase risks to the safety and stability of the prison regime. Availability of drugs inside prisons creates an illicit economy that can fuel debt, which can lead to assault, extortion or self-harm. Prisoners who are using illicit drugs often reoffend after leaving prison. 2 Effective interventions require HM Prison and Probation Service (HMPPS) and health service providers, commissioned for prisons in England by NHS England (NHSE), to work closely together. • HMPPS is primarily responsible for action to detect illicit drugs and prevent their conveyance into prisons, and it also seeks to reduce demand for drugs through initiatives to encourage positive behaviour changes. • Health service providers deliver drug treatment and recovery services inside prisons. • The overall prison environment can support prisoners by providing a rehabilitative culture; education and other purposeful activities; building relationships; delivering a safe regime; and facilitating access to health interventions, including addressing mental health needs. Focus of our report 3 This report focuses on how the prison and health services are using public funds to tackle drug harms in prisons. It examines: • how well the Ministry of Justice (MoJ), HMPPS, Department of Health & Social Care (DHSC), NHSE and wider government understand the scale and nature of drug harms in prisons (Part One); • the funding available for HMPPS and NHSE to tackle drug harms in prisons, and how resources are prioritised (Part Two); and • how effectively resources have been used and how well the prison and health services work together (Part Three).4 The report focuses only on illicit drug harms in prisons. We do not cover national and international work by the police and others to counter criminal activity supplying drugs to prisons, nor do we review interventions for people on community orders or the continuity of drug treatment services for prison leavers. ‘Substance misuse’ is a broader term often used in healthcare, which includes misuse of alcohol and diversion of prescription medicines, as well as illicit drugs. We touch on these broader issues where relevant, but they are not the focus of our report. While HMPPS is responsible for prisons in England and Wales, healthcare in Wales is a devolved function provided by NHS Wales, and therefore falls outside the scope of this report