New psychoactive substances play a part in yet more prison deaths, says Ombudsman

The number of prisoner deaths in which the use of new psychoactive substances (NPS) may have played a part has now risen to at least 58, said Prisons and Probation Ombudsman (PPO) Nigel Newcomen. Today he spoke to prison staff at the National Offender Management Service training centre in Warwickshire.

Discussing the risks to prisoners and prison staff from new psychoactive substances (NPS), Nigel Newcomen drew on lessons from his earlier publication of July 2015 which looked at the deaths of 19 prisoners.

Download the Ombudsman’s full speech.

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Nigel Newcomen said:

“The statistics are alarming. My office has now identified 58 deaths in prison that occurred between June 2013 and January 2016, where the prisoner was known, or strongly suspected, to have been using NPS before their death. It is important to note that the link between NPS and the deaths were not necessarily causal, but nor can they be discounted.”

Of these deaths:

• 39 were self-inflicted – some involved psychotic episodes potentially resulting from NPS. For others, NPS use or associated drug debts appeared to exacerbate vulnerability triggering suicide and self-harm;
• two were homicides, both involving prisoners killed by a punch from another prisoner. In one instance, the victim had links to NPS. In the other, the perpetrator was linked to NPS;
• nine were classified as natural cause deaths where the deceased was thought to have been an NPS user at the time of death;
• in three cases, the cause of death was not ascertained but NPS could not be ruled out as a possible factor in the death; and
• five deaths were the result of drug toxicity – in two cases the post-mortem concluded that NPS was the cause of death. In a further case, the pathologist found that NPS was the most likely cause of death. In another, the pathologist attributed the death to mixed drug toxicity – the toxicology test detected a number of drugs including NPS. In the last case, the post-mortem concluded that heroin toxicity was the cause of death, but the man was also known to have used NPS.

Mr Newcomen highlighted the four types of risk from NPS:

• a risk to physical health – NPS use may hasten the effects of underlying health concerns;
• a risk to mental health, with extreme and unpredictable behaviour and psychotic episodes, sometimes linked to suicide and self-harm;
• behavioural problems, where the NPS user has presented violent or aggressive behaviour, which is often uncharacteristic for that prisoner; and
• the risk of debt or bullying, as the use of NPS often results in prisoners getting into debt with prison drug dealers.

He also highlighted five areas of learning to tackle the risks posed by NPS in prisons.

• first, supply needs to be reduced. Trafficking in NPS needs to be tackled by effective local drug supply and violence reduction strategies;
• second, staff awareness needs to be increased. Prison staff need better information about NPS, and how to spot that a prisoner is taking them;
• third, governors need to address the bullying and debt associated with NPS robustly;
• fourth, drug treatment services need to address NPS use and offer appropriate monitoring and treatment; and
• fifth, demand for NPS among prisoners needs to be reduced, with prisons and healthcare providers ensuring that there are engaging education programmes for prisoners outlining the risks of using NPS.

Mr Newcomen went on:

“I and my staff are not experts on NPS. Nor is expertise all that easy to find. NPS are made up of a wide array of relatively new and regularly changing substances, for which testing is still in its infancy.

“Many NPS are readily available in the community and most are cheap. This ready availability and low cost in the community also means that in custody, the potential profits to be made from NPS make them attractive to organised and semi-organised crime.

“These features compound the difficulty of reducing supply and demand for NPS in prisons. They also often make it difficult to draw definitive conclusions in my investigations about their health impact and links to fatalities.

“However, I am clear that NPS have been a game-changer in terms of reducing safety in prison, with troubling links to our rising numbers of suicides, as well as to other types of death, including deaths from drug toxicity, apparent natural causes and even homicides.”