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Reducing prescription misuse

A muscle sprain, or a bad back, which needs more than paracetamol to ease the pain, brings problems for the sufferer wherever they are, but in a prison those problems are multiplied.

If a prisoner needs painkillers, or any medication that someone else in the prison could use as a trading tool, that prisoner can be the subject of harassment or bullying to make sure that they spin the best story possible to the medical staff and hand over whatever painkillers they manage to acquire.

One prison in the South of England has overcome this problem with a combination of modern technology and an innovative approach – they use a system to measure out, pack up and label daily doses of medication so that it clearly belongs to a specific person and they have used alternative painkilling methods to reduce prescriptions by 70 per cent.

The healthcare team, working with prison staff at every level, developed initiatives to reduce the trading of medication within the prison, to improve ease of use for prisoners, and to offer alternatives to painkillers where possible. The approach included addressing the question of who was entitled to wait outside the dispensary, an area which attracted the wrong sort of attention in the past.

Opioid prescriptions have fallen by 70 per cent since February 2011 and Her Majesty’s Inspectorate of Prisons has suggested that other prisons could benefit from the system, which draws on prisoners’ own experiences in introducing the new routines through the Prison Council of elected prisoners who discuss and comment on healthcare issues.

Tackling the problem from several angles, the approach started by using a Unidose machine, a new step for any UK prison. The machine automatically counts, packs and delivers individually-prepared daily doses.

This reduces the risk of medication being traded, enables prison officers to identify those with genuinely prescribed medication and helps individuals, who may forget to take their medication, to better manage their health.

The use of TENS machines to control pain, especially for those with bad backs, has also been introduced.  This addressed the apparent demand for stronger pain relief without increasing the prescription of stronger drugs. Prisoners with persistent back pain come into the healthcare centre as in-patients so their ease of movement can be monitored over a longer period and alternatives treatments offered.

The effects have been dramatic and have seen the team receive an award for their innovative practice that has seen the increasing wellbeing of prisoners and the reduction of unwanted behaviours.

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