Cannabis Was the Most Common Drug Used Inside Indian Prisons by Opioid-Dependent People
Among opioid-dependent people in India who had been imprisoned, 65% used drugs during incarceration, with cannabis being the most commonly used substance inside prison at 35%.
Quick Facts
What This Study Found
Researchers surveyed 101 opioid-dependent people attending drug treatment clinics who had contact with the criminal justice system. Most (85%) had been imprisoned at least once, and drug use continued during incarceration at high rates.
Before imprisonment, opioids were the most commonly used daily substance (68%), followed by cannabis (34%) and alcohol (22%). Inside prison, the pattern shifted: cannabis became the most common substance (35%), followed by opioids (19%). This shift likely reflects differences in drug availability within prisons.
After release, 76% resumed substance use quickly, and 13% of opioid users experienced overdose soon after release, a well-documented period of heightened risk due to reduced tolerance.
Prior cannabis use, injection drug use, and opioid use before imprisonment all predicted continued substance use while incarcerated.
Key Numbers
101 participants. 85% had been imprisoned. 65% used substances during imprisonment. Cannabis was most common in prison (35%), surpassing opioids (19%). 76% resumed use after release. 13% of opioid users experienced post-release overdose.
How They Did This
Cross-sectional study using purposive sampling of 101 opioid-dependent individuals attending two community drug treatment clinics in India. A specifically designed assessment tool recorded criminal acts and substance use patterns before, during, and after their last imprisonment.
Why This Research Matters
This study documents that incarceration does not stop substance use and that drug availability within prisons shapes which substances people use. The shift from opioids to cannabis during imprisonment, and the high rate of opioid overdose after release, highlights the need for evidence-based drug treatment within the criminal justice system rather than relying on incarceration as a deterrent.
The Bigger Picture
The transition from opioids to cannabis during incarceration suggests people adapt their substance use to what is available rather than stopping entirely. The high post-release overdose rate underscores that reduced tolerance during incarceration creates a life-threatening window when people return to opioid use at pre-incarceration doses.
What This Study Doesn't Tell Us
This was a convenience sample from two clinics in India and may not represent all opioid-dependent incarcerated populations. Self-reported drug use during imprisonment may be underreported due to stigma and legal consequences. The cross-sectional design cannot establish causal relationships.
Questions This Raises
- ?Does the shift to cannabis use in prison represent harm reduction compared to continued opioid use?
- ?Would providing medication-assisted treatment in Indian prisons reduce post-release overdose deaths?
- ?How do patterns of in-prison substance use differ across countries and prison systems?
Trust & Context
- Key Stat:
- 65% used substances during incarceration; cannabis was most common (35%), overtaking opioids.
- Evidence Grade:
- Preliminary evidence from a small cross-sectional study at two clinics in India. Useful for identifying patterns but limited by sample size and geographic specificity.
- Study Age:
- Published in 2016. The intersection of incarceration and substance use treatment continues to be debated globally.
- Original Title:
- Factors Affecting Drug Use During Incarceration: A Cross-Sectional Study of Opioid-Dependent Persons from India.
- Published In:
- Journal of substance abuse treatment, 61, 13-7 (2016)
- Authors:
- Rao, Ravindra(2), Mandal, Piyali, Gupta, Rishab, Ramshankar, Prashanth, Mishra, Ashwani, Ambekar, Atul, Jhanjee, Sonali, Dhawan, Anju
- Database ID:
- RTHC-01246
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do people stop using drugs in prison?
No. In this study, 65% of opioid-dependent people used substances during incarceration. The pattern shifted from primarily opioids before prison to primarily cannabis during imprisonment, reflecting differences in drug availability.
Why did cannabis replace opioids as the primary drug in prison?
The study did not investigate this directly, but cannabis is generally more available and easier to conceal in prison settings. The shift suggests people use what is available rather than stopping substance use entirely during incarceration.
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Cite This Study
https://rethinkthc.com/research/RTHC-01246APA
Rao, Ravindra; Mandal, Piyali; Gupta, Rishab; Ramshankar, Prashanth; Mishra, Ashwani; Ambekar, Atul; Jhanjee, Sonali; Dhawan, Anju. (2016). Factors Affecting Drug Use During Incarceration: A Cross-Sectional Study of Opioid-Dependent Persons from India.. Journal of substance abuse treatment, 61, 13-7. https://doi.org/10.1016/j.jsat.2015.08.009
MLA
Rao, Ravindra, et al. "Factors Affecting Drug Use During Incarceration: A Cross-Sectional Study of Opioid-Dependent Persons from India.." Journal of substance abuse treatment, 2016. https://doi.org/10.1016/j.jsat.2015.08.009
RethinkTHC
RethinkTHC Research Database. "Factors Affecting Drug Use During Incarceration: A Cross-Sec..." RTHC-01246. Retrieved from https://rethinkthc.com/research/rao-2016-factors-affecting-drug-use
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.