REPORTS OF THE COURSEGROUP 1EFFECTIVE TREATMENT MODALITIES AND INTERVENTIONSFOR INCARCERATED DRUG USERS
Rapporteur: Ms. Nanja LIMBO (Namibia)
Co-Rapporteurs: Mr. Eduardo Tomio TAKATA (Brazil)
Mr. Suhaizak AB.WAHAB (Malaysia)
Chairperson
Co-Chairperson
Members

Advisers

Mr. Deepak R GUNNOO
Ms. Keiko KOMINO
Ms. Eko K MANGERE
Mr. Masashi YAMANE
Ms. John J SMITH
Mr. Thet P SOE
Mr. Yuen T LAM
Mr. Toru NAGAI
Prof. Mana YAMAMOTO
Prof. Hidenori OHINATA
Prof. Ryo FUTAGOISHI
Prof. Hiroyuki WATANABE(Mauritius)(Japan)(Papua New Guinea)(Japan)(Samoa)(Myanmar)(Hong Kong)(Japan)(UNAFEI)(UNAFEI)(UNAFEI)(UNAFEI)

I. INTRODUCTION
thThe 170 International Training Course held by the United Nations Asia and Far East Institute for thePrevention of Crime and Treatment of Offenders (UNAFEI) is aimed at creating a platform that offersinternational views regarding improving effective treatment of illicit drug users. During group discussions,which are a major component of the above-mentioned training programme, participants were called upon toexpress their expert opinion on the following topics: A. Treatment Methods in Prison; B. Coordination andCooperation between Prison and Community Organizations. Illicit drug users are viewed as the most at-risk
population with multiple health problems encompassing the physical, mental, social and psychologicaldimensions as a result of prolonged precarious lifestyles. Furthermore, this populationʼs risk factors amplify
when entering correctional settings

II. ISSUES AND CHALLENGES
Challenges were noted to differ from country to country, yet several similarities were agreed upon duringextensive discussion sessions:
1. Lack of Trained Personnel: Treating drug users within correctional settings requires adequately
trained personnel to effectively and efficiently provide optimal treatment interventions. However, it has
been unanimously noted that lack of knowledge and training among the correctional staff in specificrehabilitation approaches will contribute to ineffective treatments and high relapse/reoffending rates.
2. Specialized Assessments: Illicit drug users require specific assessments to identify the risks and needs,
because they have multifactorial social problems and chronic health disorders. However, comprehensive
assessment tools that focus on detecting the multiple risks are lacking. Furthermore, the group noted thatmost existing assessment tools are not gender and age specific.
3. Diversity of Drug Use Programmes: Evidence-based treatments such as relapse prevention
programmes, cognitive behavioural therapy and motivational interviewing are actively utilized within thecorrectional settings. However, since drug users have multifactorial health disorders, the public healthapproach of harm reduction is lacking within most correctional treatments as most programmes are notdiverse. Additionally, currently implemented programmes lack systematic monitoring and evaluation
mechanisms to assess effectiveness of interventions and training.
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4. Lack of Community Support and Partnership: Considering that the UNODC strongly advocates foralternative treatment for drug users, the lack of strong community support and partnership withcorrectional services decreases the success rate of treatment, as an extensive part of drug use treatment
is the provision of community-based treatment programmes.

III. BEST PRACTICES
1. Training: Mandela Rules 75-76 emphasize training for correctional officers. Based on best practices
discussed, it is suggested that every country is required to conduct a training-needs analysis to haveadequately trained personnel for drug treatment programmes. Training should focus on enhancing
assessment skills and optimal service delivery. Training strategies should comprise the following:a. Specific training from external expertise: (selecting officers to attend academic training at universities
and professional training bodies to obtain relevant qualifications). Hong Kong Correctional Services
Department provides for selected officers to obtain certificates in Social Work for Correctional Service.
b. In-service training provided by internal experienced staff and external experts (legal, medical, social,community-based organizations, like DARC in Japan).
2. Drug Use Assessments: Risk and needs assessments are critical for early detection. Assessment tools for
drug users should be able to assess the risk of relapse and reoffending in order to match programmeintervention intensity, while also detecting the risks of infectious diseases (HIV, TB, and Hepatitis) andmental health disorders. The UNODC recommends the use of the SBIRT approach as a screening
protocol to identify people with drug use in non-specialized healthcare settings such as corrections. The
approach has been proven effective by SAMHSA (US)1, and it allows flexibility in utilizing assessment
tools. Furthermore, ASSIST2, DAST 203 and C-SRRS4 are considered as appropriate tools to use during
screening.
3. Diversified Programme Options: The unique multifactorial risks and needs of drug users require
diversified rehabilitation programmes as follows.
PsychologicalPharmacology

SocialCognitive Behavioural
Therapy (use virtual
reality stimulation androle play-Dr Zhang)-

Family involvement (Probation
Office Family Programme-Japan)-

Detoxification treatment(Buprenorphine-Mauritius)-

Religious support / activities--

Self Help Groups - 12steps programmes-

Art, Physical Exercise, CulturalActivities

Substitutiontreatment
and Maintenance therapy(Methadone-Mauritius)-

Behvioural
Therapypositive reinforcement-

Educational and Vocational skills--

Alternative programme (Weekend
Release-Samoa)

RelatedPharmaceuticaltreatment (Mental Health
Treatment-Japan / Brazil)-

Cooperation with external bodies
in prison (DARC-Japan)-It is suggested that voluntary treatment is the ultimate goal; however, mandatory treatment for drugusers within correctional facilities is equally important under special circumstances, such as life-threatening
Pg. 4 Screening, Brief Intervention and Referral to Treatment in Behavioral Healthcare, Substance Abuse and Mental HealthServices Administration, US2Pg. 21 International Standards for the Treatment of Drug Use Disorders, UNODC
3Pg. 363-371 The Drug Abuse Screening Test, Addictive Behaviours, Skinner. H.A. (1982)
4Development of the Correctional Stimulant Relapse Risk Scale, Yamamoto et al (2011)1112

170TH INTERNATIONAL TRAINING COURSEREPORTS OF THE COURSE

situations, etc., as stipulated in the Drug Dependence Treatment: Interventions for Drug Users in Prison bythe UNODC5.
4. Community-Based Partnership: Mandela Rules 107-108 support the early involvement of communitybased organizations in treatment programmes, in order to coordinate the offendersʼ treatment effectively.
Community partnership should be adopted as follows:a. The throughcare approach provides for continuous assessment and assistance from the first contactwith the criminal justice system for drug users. It entails providing pre-sentencing, during
incarceration and aftercare treatment and support from community and governmental agencies.
There is a publication validating the effectiveness of this treatment method in the U.K.6
b. Aftercare is an essential component to assist drug users to reintegrate into society after release. The
Volunteer Probation Officer approach in Japan could be considered as a good practice because
community members actively participant in the aftercare of drug users by establishing halfway houseservices.
c. Public awareness is instrumental to enhancing effectiveness of rehabilitation programmes for drugusers as it helps appeal for acceptance and support in the community. A good practice is engaging
community stakeholders through utilizing channels such as social media, publications, symposiums andrehabilitation ambassadors (Rehabilitation mascots, Hogo Chan and Sara Chan).

IV. CONCLUSION AND RECOMMENDATIONS
In conclusion, the best practices mentioned above are evidence based and are reported to have great
impact on the treatment of drug users in several countries. However, it is also argued that ensuring
effectiveness of recommended treatment interventions requires a systematic evaluation process. Additionally,gender and age sensitivity should be focal considerations during the assessment and treatment phases.
The most important recommendation is for policymakers to acknowledge and align existing criminal
justice laws with current public health policies, including harm reduction strategies (Portugal is aninternational benchmark)7.

Pg. 28 Drug Dependence Treatment: Interventions for Drug Users in Prison, UNODC
Pg. 60 Drug Dependence Treatment: Interventions for Drug Users in Prison, UNODC
7Ms Anja Busse Presentation on 3 Sept 2018 Treatment for People with Drug Use Disorders in Contact with the Criminal
Justice System: Alternatives to Conviction or Punishment
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