TREATMENT OF DRUG OFFENDERS IN THE MAURITIUS PRISONSERVICE
Joanna Figaro-Jolicoeur＊

I. DRUG SITUATION IN MAURITIUS
Substance abuse and illicit trafficking is a matter of serious concern throughout the world. Even theRepublic of Mauritius has not been spared to that scourge. Situated in the Indian Ocean, it is a small islandwith a population of approximately 1.35 million1.The country is facing an unprecedented situation from drugtrafficking and drug use, posing a threat to its national security and public health. Mauritius recorded, in 2016,
an estimated market value of about 10m USD on seized drugs. Cannabis is one of the most popular drugs
available in the Mauritian market, with an increase of 4% compared to year 2015, due to its easy cultivationon our island2. Since 2013 there is an emerging demand for new psychoactive substances. The supply isabundant due to the ease with which these drugs are imported and cheap price which leads to its easy
availability among the young public.
The country has passed a number of laws in order, on one hand, to curb drug trafficking, money
laundering and financial crime and, on the other, to provide evidence-informed policies and interventions toprotect and promote the health and well-being of its citizens. The Dangerous Drug Act 2000, the HIV andAids Act 2006, the Financial Intelligence and Anti Money Laundering Act 2002, henceforth known asFIAMLA, POCA (2002), the Bank of Mauritius Act 2004 are examples of this legislation.

II. CURRENT SITUATION
Problematic drug users are among the most vulnerable among prisoners and are over-represented within
the prison population, often due to a growing trend towards the criminalization of drug use and possession
and the use of custodial sentences for drug-related crime.
Effective delivery of drug interventions is key ̶ until drug addiction can be broken, offenders remain
dysfunctional and incapable of engagement with programmes that, collectively, help them lead law-abiding
lives on release. Prison represents the first opportunity for offenders to have their drugs-misuse problems
addressed in a coherent, structured way.
Against this backdrop, the Prison Service is tasked with addressing the needs of individuals who are both
dysfunctional and often unable to engage effectively with others. The demand for drug interventions,therefore, places the prison system under considerable pressure.
Since implementation of Methadone Maintenance Therapy (MMT) in 2006 in the community, the Prison
Service ensured continuity of methadone therapy to detainees already induced at community level.However
since December 2011, a methadone induction unit has been set up for induction and dispensing of methadone
for People Who Inject Drugs (PWID). Drug rehabilitation programmes are delivered in different prison
institutions to those people.
A team of healthcare workers comprising of Prison Doctors and Nurses provides round-the-clock medicalservice, assisted by a full time psychologist, Prison Welfare cadre, and trained Prison Officers, at reducing theHospital Officer, Mauritius Prison Service, Mauritius.
Indexmundi.com. (2018). Mauritius Demographics Profile 2018. [online] Available at: https://www.indexmundi.com/mauritius/demographics_profile.html [Accessed 23 Apr. 2018].
2
Statsmauritius.govmu.org. (2018). Statistics Mauritius - Crime, Justice and Security Statistics - Year 2016. [online] Available at:
http://statsmauritius.govmu.org/English/Publications/Pages/CJS_Stats_Yr2016.aspx [Accessed 22 Apr. 2018].
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supply of illegal drugs into prison ̶ through a range of practical supply reduction initiatives ̶ and at
reducing the demand for drugs among prisoners through effective treatment interventions, clinicallymanaging their withdrawal from drug dependency, providing rehabilitation, and support to remain drug-free.
About 60% of those admitted into prison are problematic drug-misusers (PDMs) with about 75% reportingsome drugs-misuse; With an annual through-flow of about 7,500 offenders, an average of 4,500 drug-misusing
prisoners may be in custody during the course of a year, with about 1,200 being present at any one time, outof which 11.4% are HIV positive cases. The total prison population as at March 2018 was 2,354 and 13.9%
were on MMT.
The Mauritius Prison Service manages 7 prisons for men and 2 for women, a rehabilitation youth centre
and a correctional youth centre. In 2017, the prison recorded an admission rate of 7,517 out of which 3,027
averred to be intravenous drug users. During that same year 317 were convicted due to offences directly
related to drug:
Offence

Number

1. Drug Possession/Use211

2. Drug Dealing61

3. Drug Trafficking

33

4. Drug Importation

12

III. CHALLENGESi.

Prisons are not therapeutic institutions;ii. The prison staff and administration often do not have the capacity to respond adequately to the healthproblems of drug users;iii. Many drug users in prison are serving short-term sentences or are on remand, which means the time
available for therapeutic interventions is often limited;iv. Diversion of methadone is becoming a recurrent feature in prison;v. Few cases of overdose have been reported;vi. Impersonation during methadone dispensing;vii. Sharing of unsterile injecting equipment.

IV. WAY FORWARD
Due to the chronic relapsing nature of drug dependence and the need to address social and psychologicaldimensions, achieving abstinence for many people is often a lengthy and difficult process. The period of time
when a prisoner is incarcerated represents an opportunity to intervene in the cycle of drug use and crime
and to reduce the harms of drug use.
Therefore, to address the underlying causes of addiction, a proposal is made for the establishment ofresidential rehabilitation based on the principle that a structured, drug-free environment provides anappropriate context for treatment. The programme will be developed to assist drug users in developing
appropriate skills and attitudes to make positive changes towards a drug-free way of life. Thus, TherapeuticCommunities (TCs), a subset of residential rehabilitation characterized by an emphasis on accepting personal
responsibility for decisions and actions, will be established.

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The objective of drug dependence treatment is the achievement and maintenance of physical,
psychological and social well-being through reducing the risk-taking behaviours or practices associated withdrug use or through abstinence from drug use.
Action to reduce prison populations and prison overcrowding should accompany ̶ and be seen as anintegral component of ̶ a comprehensive strategy to prevent HIV transmission in prisons, to improve prison
health care, and to improve prison conditions. This should include:# The development of non-custodial strategies to reduce the over-incarceration of drug users and toestablish government targets for reducing prison overcrowding generally;# Multi-sectoral collaboration among law enforcement, health, judiciary, human rights, social welfare
and drug control institutions to assist in developing frameworks of action to support people who usedrugs;# Setting up of a drug court to expedite referral of drug users to the Drug Detention and TherapeuticCentre;# To establish a drug and detention treatment centre under the jurisdiction of the Mauritius PrisonService exclusively for the purpose of rehabilitation and treatment of substance use disorders;# Capacity-building of officers selected to work in this centre.
In view of the increasing number of detainees on methadone, and to curb the problem of diversion, aseparate institution should be identified to accommodate methadone recipients in prison. This measure wouldenable the provision of comprehensive services in terms of support and rehabilitation. The creation of aseparate harm reduction unit with trained and adequate personnel is highly important to provide care,treatment and support to these groups of detainees.
Nongovernmental organizations are also lending a helping hand in the harm reduction programme. Closelinks between prison and public health services will be strengthened for prisoners to have access to an
appropriate quality of healthcare.

V. CASE STUDY
The Prison Department receives admission on a daily basis and for several offences. Recurrent cases thatare received are those related to drugs. On admission, detainees go through an induction programme wherethe detainees are informed about their rights and privileges and prison rules during the period ofincarceration and at the same time the Prison Staff obtain baseline information on the detainees regarding
their health status and behaviour patterns. This programme is conducted with a panel of Prison cadre namely
Prison Officers, Welfare Officers and the health care team.
The drug problem remained a priority issue in the Mauritius Prison Service. So far, several stakeholders
are collaborating with the prison service to address the drug issue among detainees, including Non
Governmental Organizations (NGOs), during the incarceration period and on discharge.
Since each detainee has a specific perception and attitude towards his offence it is important to modify
their risky behaviour. Therefore, the Transtheoretical Model describes the process of behaviour change andaccounts for an individualʼs readiness to make and sustain behaviour changes. This model is useful as it helps
planners design programmes based on an individualʼs readiness, motivation, and ability. It was developed byProchaska and DiClemente in the late 1970s, to monitor the steps in changes and focuses on decision making3.
During the Induction Program, the inmates are encouraged to join the Drug Rehabilitation Program indifferent Prison institutions. But the study was mainly focused on the Beau Bassin Prison. On three

3Wayne, W. 2016.Behavioural Change Model. Boston University School of Public Health. (accessed on 26 Apr 2018)

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consecutive days, intravenous drug users were identified on admission. 35 detainees started an awarenessprogramme for about three weeks. The programmes were carried out by Prison health professionals,
Welfare Officers and NGOs.

VI. SELECTION CRITERIA
The main criteria were to identify people who inject drugs on admission. The 35 participants were maleconvicted detainees with more than 6 monthsʼ imprisonment. All 35 detainees attended the awarenessprogramme.
The Transtheoretical Model of Change comprises 5 stages4:i.

Pre-contemplation

ii. Contemplationiii. Preparation
iv. Action
v. Maintenance

A. The Pre-contemplation PhaseAt this stage the individual has no intention to change. Two detainees among them previously embarked
on unsuccessful attempts. This previous experience made an impact on the actual situation as they werediscouraged.
Education is of utmost importance to pull the detainees out of ignorance. With the support of NGOs,awareness and sensitization classes were conducted. The time spent from pre-contemplation to move to thenext stage depends on each individual. 5 detainees were identified as being very participative and showing
willingness to change. As the Methadone Induction Program enrolled batches of 5 participants at a time, thefive detainees were selected to step ahead. The project milestones were explained to them and all theiruncertainty was being clarified. The 30 remaining participants were involved in other sensitization
programmes; Alternative activities were established to encourage these clients to give up their previous
habitual behaviour patterns until the next intake of methadone induction therapy in prison.

Extension.purdue.edu. (2018). [online] Available at: https://extension.purdue.edu/extmedia/HHS/HHS-792-W.pdf [Accessed 26Apr. 2018].
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B. Contemplation
In the contemplation stage people are more aware of the personal consequences of their bad habits, andthey spend time thinking about their problem. Although they are able to consider the possibility of changing,
they tend to be ambivalent about it. In this stage, the individual weighed the pros and cons of quitting drugs
or modifying their behaviour. The five detainees were moving toward healthy behaviour.
C. Preparation Phase
The 5 detainees are prepared to adopt another lifestyle. Psychological support is provided in order to help
them to set goals and priorities to change. They were given one hour individual counselling sessions per day.
A detainee worksheet was introduced to assist them during this phase. The five detainees were asked toidentify barriers that prevent them from stopping drug abuse. A team of 3 trained Prison Officers wasentrusted to work according to the detaineesʼ particular problems. For example, some wanted to change cellso as to avoid gangs whereas others preferred to avoid remaining idle in the yard so as to avoid visualtriggers induced by other drug using inmates. The hospital staff assisted the detainees to work on
introspection. At the sight of drugs, they postpone their decision to change. So they were placed in anothercell during the night and placed in the day care rehabilitation unit to avoid exposure with detainees involvedin drug use. More information was given to them about the Methadone Induction programme in prison.
D. Action Phase
In this stage, the 5 detainees start implementing direct action in order to accomplish their goals. The main
action that was focused on was to stop injecting drug. They were placed in the self-care unit designed for
those on methadone. Health-related posters were placed in their dormitories and pamphlets were distributed.
After a couple of days, it was noted that two detainees presented with withdrawal symptoms: muscle
cramps, body pain, and runny nose etc, which was a good sign prior to start methadone therapy. They werereferred to the medical section to evaluate their health status and eligibility for induction to the methadone
programme. After assessment, they were found suitable for enrolment for the programme. Both of themstarted the harm reduction programme. According to their behavioural pattern and to urine tests performed
after six months of the project, the other 3 inmates were maintaining drug-free lifestyles.
Emotional support and family bonding is important during that phase. Welfare officers arranged forregular visits and even close contact visits were allowed at time.
E. Maintenance Phase
The prime concern of this phase was to involve the social environment of the detainees in order to acquire
efficient rehabilitation. Welfare Officers were requested to contact their family members. NGOs wereworking with the participants and their families. At the end of the project the detainees were compliant withthe treatment. Regular follow-up to assess the 3 participants that were not induced on methadone reveal thatthey were maintaining drug-free lifestyles. They were encouraged to motivate other detainees to join theharm reduction programme.

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