It is known that prisoners generally have poor health and complex health needs that are reflected in the number and types of medications they take. Less is known about how this medication use compares with people in the general community. This bulletin uses data from the Australian Institute of Health and Welfare's National Prisoner Health Data Collection and the Australian Bureau of Statistic's National Health Survey to compare medications taken by prisoners with people in the general community. Contextual information from a focus group of prison health professionals is used to discuss some of the differences between prescribing in a prison and in the general community.
Use higher for mental health, addictions and other chronic conditions
The types of medications where the difference between prisoners and the general community was the greatest were for those medications usually taken for mental health problems, addictions and chronic conditions. These are areas in which prisoners are known to have poorer health than the general community.
Compared with the general community, prisoners were 9 times as likely to be taking antipsychotics, more than twice as likely to be taking antidepressants or mood stabilisers, and 4 times as likely to be taking medications used in addictive disorders.
The proportion of people taking many types of medication for chronic conditions increases with age. Among prisoners, this increase started earlier and was steeper than for people in the general community. Medications for high blood pressure, high cholesterol, asthma and diabetes were taken by a higher proportion of prisoners than the general community by age 30–39 years. For anti-inflammatories these differences were found for those aged 40–49 and older.
Reasons for differences in prescribing are complex
Certain aspects of the prison environment may influence prescribing practices. Prisoners have limited access to over-the-counter medications, and are usually not allowed to keep medications in their possession, so some medications that may be purchased without prescription in the community are likely to be prescribed in prison. The choice of prescribed medications may be influenced by security considerations, such as the daily prison schedule, and the 'direct administration' of medications whereby prisoners are provided with, and take, medications under supervision. As in the general community, some medications, such as antipsychotics and benzodiazepines, are considered to be 'tradeable', and the prescription, possession and taking of these medications are closely monitored.