Screening tool shows promise in predicting substance use after prison release

Research from The University of Western Australia has revealed that a simple screening tool could help identify those people most at risk of returning to substance use after release from prison, potentially cutting down drug-related injuries and deaths.

“The substantial rates of return suggest that prison serves to interrupt rather than cease substance use.”

Craig Cumming, UWA School of Population and Global Health

The study, published in the journal Addiction, looked at the predictive ability of the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) in picking up cannabis, methamphetamine, heroin and other opioid use in people in the first six months after release from prison.

Lead author Craig Cumming, a research associate from UWA’s School of Population and Global Health, said the research was conducted in Queensland and involved 1054 adults who were within six weeks of expected release from prison. 

“We used the test to assess problematic substance use before incarceration and then followed up with participants to measure substance use at one, three and six months after release,” Mr Cumming said.

“The results showed that 41 per cent of participants reported substance use during follow-up, with 33 per cent using cannabis, 20 per cent using methamphetamine, 10 per cent using heroin and 9 per cent using other illicit opioids.”

Image: The study involved 1054 adults who were within six weeks of expected release from prison.

Mr Cumming said the statistics highlight the high rates of people leaving prison who return to drug use after release.

“The substantial rates of return suggest that prison serves to interrupt rather than cease substance use,” he said.

“Rates of use are higher in people moving through prison compared to the general population and, consequently, after release from prison these individuals face an elevated risk of substance-related harms – including fatal and non-fatal overdoses, injury and an increased risk of reincarceration.”

Despite the known risks, Mr Cumming said there was a substantial unmet need in most countries for alcohol and other drug treatment services after release from prison, which is where the ASSIST could help.

“The ASSIST can be routinely used in prisons to ensure that throughcare alcohol and other drug treatment resources are targeted towards individuals who need them the most, in an effort to reduce the risk of substance-related harm after returning to the community,” he said.

“Substance treatment in prisons alone is demonstrably insufficient to prevent returning to risky use, and associated harms, after release from prison. Ongoing treatment and support during the period after release is crucial.”