Use of Psychoactive Substances Before Incarceration Among Prison Inmates With Drug Abuse or Dependence: Data From the OPPIDUM Program

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BACKGROUND: The objective of this study was to assess the prevalence of dependence and abuse of psychoactive substances (PAS) among prison inmates, using data from the OPPIDUM program between 2013 and 2022. METHODS: OPPIDUM is an annual, cross-sectional national program, conducted among users consulting in specialised addiction centres. Prison inmates were questioned about their PAS use during the week preceding their incarceration. Two groups of participants were compared: prison inmates who reported simple use of PAS and those with abuse/dependence problems. RESULTS: A total of 2626 individuals responded to the program (men, 91.6%; mean age, 34.4 ± 9.30 years), reporting 5352 PAS. The main PAS consumed were cannabis (52.8%), cocaine/crack (28.6%), benzodiazepines (23.1%) and heroin (14.8%). Opioid substitution treatment (OST) was reported by 54.9% of participants. Several variables were associated with a significantly increased odds of abuse/dependence: intravenous use (OR, 4.608; 95% CI, 1.44-14.69; p = 0.01), PAS illegal acquisition (OR, 3.79; 95% CI, 2.19-6.58; p < 0.0001), heroin/speedball use (OR, 4.24; 95% CI, 1.16-15.48; p = 0.029) and cocaine/crack use (OR, 3.3; 95% CI, 1.47-7.39; p = 0.004). Conversely, being on OST protocol was associated with a lower odds of abuse/dependence (OR, 0.511; 95% CI, 0.28-0.93; p = 0.028). LIMITATIONS AND CONCLUSION: The main limitations of the study include self-reported PAS use without objective diagnoses, sometimes incomplete data on PAS use and incarceration and a sample biased toward inmates linked to substance abuse services, which likely overestimates the prevalence of PAS use. However, these results highlight the importance of assessing factors associated with substance abuse and dependence for appropriate prevention and management among prison inmates.

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