The Australian Institute of Health and Welfare identified in its 2023 Health of people in prison report that the misuse of alcohol and other drugs can lead to poor health outcomes and antisocial behaviours, and is a primary motivating factor in many crimes. People entering the prison system are at an increased risk of harmful use of alcohol and other drugs, and the associated impact on health, and increase in antisocial behaviour. In 2019, the Queensland Productivity Commission found that drug offences had contributed notably to the growth in imprisonment in Queensland. Between 2012 and 2018, drug offences contributed to 32% of the increase in Queensland’s sentenced prison population. Prisoners with drug offences make up 22% of Queensland’s female population and 15% of the male population.
Highlighting the impact of substance misuse on prisoners, the Australian Institute of Health and Welfare found:
- about 44% of prison entrants were at high risk of alcohol-related harm during the previous 12 months
- almost 64% of prison entrants reported they smoked tobacco daily
- almost 73% of prison entrants reported using illicit drugs in the previous 12 months
- the most commonly reported drug used by prison entrants for non-medical purposes – or that was not supplied to them medically – was cannabis, with more than half (53%) reporting having used it at least once in the previous 12 months
- methamphetamines/amphetamines were also commonly used, with 46% of prison entrants reporting using them at least once in the previous 12 months
- Australian First Nations prisoners show a higher rate of alcohol, tobacco, and illicit drug use compared to non-Australian First Nations prisoners.
A similar increase is also demonstrated in a report by the Queensland Treasury in 2023, Adult illicit drug offending and criminal justice outcomes, The report compared illicit drug offences in 2012–2013 and then again in 2020–2021 and found illicit drug offending contributed to a 44.5% increase in Queensland’s sentenced prison population admissions.
The strong demand for drugs by offenders in the community is carried over into the prison environment, and its presence poses a significant risk to prison safety and security. There are fewer opportunities in prison to obtain and use illicit drugs than in the general community, as prisons use multiple strategies to reduce their supply.
This strong demand, combined with the strategies to reduce supply, can lead to prisoners taking increased risks. This can include sharing injecting equipment, with a subsequent increase in the risk of contracting bloodborne viruses. Despite the difficulty in obtaining illicit drugs, the following statistics from the Australian Institute of Health and Welfare, in its 2023 Health of people in prison report show that a significant cohort of prisoners continue to engage in substance use in custody:
- Almost 37% of people discharged from prison reported using illicit drugs in prison.
- About 14% of people discharged from prison reported injecting substances in prison.
We conclude that prisons in Queensland must have strategies to safely reduce the demand for drugs and alcohol. These must include access to specialised and individualised treatment and culturally appropriate support for prisoners with a known substance misuse history. The support must be of a standard equivalent to that available in the community.
Our inspection standards for Queensland prisons consider access to pharmacotherapy programs, under strict eligibility criteria, that offer sufficient places to meet the demand, and that prisoners under such programs are regularly and clinically monitored. Pharmacotherapy is the use of medication in the treatment of health conditions. The COPD: Health Needs, states that opioid substitution treatment (OST) is the legal administration of an opioid medication under medical supervision, and that it assists in minimising and managing cravings and withdrawals associated with opioid dependency.
Metro South HHS is funded to provide OST to prisoners at the centre, and the program is administered by a Clinical Nurse Consultant (CNC) in consultation with a doctor. At 21 May 2024, there were 18 prisoners receiving OST, with another 12 prisoners waiting for their application to be processed. Queensland Health stakeholders told us that when a prisoner receiving OST is transferred from another prison, the program will continue without any treatment delays. If a transferring prisoner’s application for OST made at another prison has not yet been approved, they must submit a new application at the centre.
We observed centre facilities where the OST program was being administered. Due to inadequate clinic spaces, the prisoners received the OST injections in the staff kitchen, with the process being interrupted twice by officers walking through. We were informed this is a common occurrence. Considering that substance use risks were also being discussed, the OST practitioners were doing their best to maintain prisoner privacy; however, this practice is not appropriate and is not a standard that any service provider in the community would accept.
The COPD: Health Needs, states that the CNC will be responsible for the vetting and assessment processes, including urine testing, of all prisoners applying for the OST program. Queensland Health’s Queensland Opioid Dependence Treatment Guidelines (2023) state that a urine drug screen can enhance the validity of patients’ self‑reported use of substances. If a prisoner at the centre is seeking treatment through the program, they are required to provide a urine test to confirm they are actively using (illegal) opioids before they can gain access to the OST program.
Prisoners are aware that a positive urine test for non-medicated opioid use is a significant breach of the centre rules, and grounds for a transfer back to a secure prison. Health practitioners informed us that prisoners were concerned they would be targeted for QCS urine testing if centre officers become aware they are providing health staff with a urine sample for an OST application.
This dynamic was identified by a treating doctor during a 2021 coronial inquest into the death in custody of a prisoner under the influence of opioids at Arthur Gorrie Correctional Centre. The doctor described the ‘parole paradigm’ and the ‘health paradigm’ which use urine test results for breach and health purposes respectively.
The Queensland Opioid Dependence Treatment guidelines specifically state that a urine test should only be ordered for clinical reasons, which should not be confused with the different purposes for which they can be used in the correctional system. By comparison, the QCS COPDs for Substance Testing and Health Needs do not give specific guidance on managing tension around the disparate ways that health staff and QCS respond to positive urine tests. We are concerned that prisoners have this perception, but we did not find evidence that prisoners were being punitively targeted for QCS urine tests immediately after a urine test for OST assessment.
In addition to the above-detailed treatment therapy, the centre offers prisoners access to therapeutic drug and alcohol programs. These programs are delivered by an engaged service provider, Queensland Injectors Health Network (QuIHN) Ltd, an independent not‑for-profit providing a range of specialist social and medical services relating to alcohol, other drug use and mental health. QuIHN delivers two group programs to prisoners at the centre:
- Short Substance Intervention (SSI) – a 12-hour group program.
- Low Intensity Substance Intervention (LISI) – a 16-hour group program.
We were told that QuIHN staff feel safe at the centre and that centre staff interact in a gentle manner with prisoners and make allowances to support engagement with programs. QuIHN stakeholders said some prisoners would benefit from individual engagement, which was not available under the current funding arrangement. A review of waitlist data from the period of inspection showed that several prisoners had been waitlisted for High Intensity Substance Intervention (HISI) and Moderate Intensity Substance Intervention (MISI). Notably, these services were not delivered by QuIHN or delivered at the centre at all.
Figure 4: Prisoners reporting their ability to access addiction support programs at the centre

Source: Compiled by the Inspector of Detention Services using information from voluntary prisoner survey responses obtained from 10 April to 15 June 2024.
One in four of the prisoners who provided a response stated that the level of addiction support available at the centre was good, with another one in four stating the support was poor, and the remaining half stating it was average.
Inspection officers did not assess the quality of programs delivered by QuIHN. However, information on the QCS intranet states that all substance misuse programs delivered for QCS have been assessed through an Accreditation Program and Services Panel. We also note that QuIHN is well established in the community as a provider of drug and alcohol services, and we assess that prisoners are receiving services to a similar standard to that available in the community.
To enhance the effectiveness of services provided by QuIHN, we consider that flexibility to provide prisoners a broader range of more intensive group programs such as MISI and HISI, as well as individual counselling, would better meet the increasing need for substance interventions. This recommendation is also consistent with the 2016 Queensland Parole System Review, which recommended that QCS should increase the number of high-intensity substance use programs available to prisoners.
We were advised by QuIHN that the centre had lengthy waiting lists for the LISI and SSI programs. This statement was also supported by information provided to our office by the centre regarding waiting lists as of 22 March 2024:
Table 2: Number of prisoners waitlisted for substance intervention programs for the period as of 22 March 2024
Program |
Number of prisoners on waitlist |
High Intensity Substance Intervention (HISI) |
5 |
Low Intensity Substance Intervention (LISI) |
38 |
Moderate Intensity Substance Intervention (MISI) |
11 |
Short Substance Intervention (SSI) |
16 |
Source: Compiled by the Inspector of Detention Services using information from Queensland Corrective Services.
Information from the centre shows a waitlist for both the SSI and LISI. The waitlist for LISI is particularly high, and prisoners informed us that the wait time can be as long as six months.
While the centre places prisoners on the waitlist for HISI and MISI, as abovementioned, neither program was available at the centre. In March 2021, an internal QCS inspection report recommended a review of funding and program hours to match the increased demand for programs such as LISI. A follow-up report dated 6 October 2021 assessed that this recommendation was partially implemented and noted that 37 prisoners were waitlisted for the LISI program, comparable to the waiting list of 38 at the time of inspection.
As was the case in 2021, there continued to be a high number of prisoners waitlisted for substance interventions, with the LISI program showing the highest number. Anecdotal and statistical evidence about increased drug activity, and the high number of prisoners on the waiting list for the LISI program, collectively confirmed an ongoing need for increased availability of substance interventions. Additionally, the centre was also seeing relatively high completion rates for LISI and SSI programs, being 70.5% and 78% respectively.
We also identified that a program called Straight Talk is provided in some prisons. The program is aimed at Aboriginal people and Torres Strait Islander people who want to ‘manage a drug and alcohol problem’ and provides the opportunity to build a healing plan with professionally trained Australian First Nations counsellors.
If the number of prisoners who identify as Australian First Nations people continues to increase, the delivery of this program at the centre should be supported, and additional support should come from increased attendance by the CLO.