A Journey of Support with AD:EPT in Maghaberry Prison

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A Case Study detailing the support journey delivered by our AD:EPT service, and partner organisations, to a young man struggling with substance use during his time in Maghaberry Prison.

AD:EPT is a therapeutic service, delivered by Start360 and funded by the South Eastern Health & Social Care Trust. The service supports individuals in custody who have issues with drugs and/or alcohol. For more information please click here.

Referral

A 24-year-old male ‘Tony’, was referred to AD:EPT in Maghaberry Prison due to ongoing substance use. During his time in custody he failed numerous drug tests, was very unsettled and experienced poor mental health.

Assessment

The assessment carried out by AD:EPT identified that Tony required specialized support in relation to trauma experienced in his childhood. Tony reported that his substance use became problematic during times in custody. He reported poor mental health, stating he had a lack of coping skills, struggled with cravings and lacked confidence. He also stated that he believed his substance use helped him manage these problems. Assessment identified his suitability for casework and the Building Skills for Recovery (BSR) programme. It also highlighted the need for mental health support and an appropriate mental health referral was made at this stage.

Casework

On commencing casework, a care plan was developed with Tony and several goals were identified. Tony wanted to develop skills for effectively coping with cravings/ urges and harm reduction. He reported that during his time in custody his misuse of opiate based substances had “got out of control”. He spoke about feeling “addicted” to these substances and struggling daily.

Tony spoke about issues from his past and he was encouraged to seek specialist support in relation to this. He was supported to access this support through the Northern Ireland Prison Service (NIPS).

Six sessions of casework were completed, with a focus on harm reduction, enabling him to make informed choices and develop his awareness around associated harm that he was exposing himself too. During these sessions Tony self-reported to NIPS staff that he was having suicidal thoughts and as a result he was placed on a SPAR (Supporting Prisoners at Risk). AD:EPT attended the SPAR review, advocating on behalf of the client.

The AD:EPT Case Worker and Tony agreed that a referral to Clinical Addiction Team (CAT) was necessary to help him cope with withdrawals, as his overall goal was to be substance free. A referral was made and at the end of our six sessions it was agreed that he would be checked in with regularly to offer ongoing support and he was referred for the BSR programme.

Continued Support

In the interim period, waiting for other services, Tony attended acupuncture sessions delivered by AD:EPT. He stated this helped him relax and spend time focusing on himself and found it very useful. He spoke about this providing him the opportunity to detach from the prison environment which he found very challenging. He attended this for 6 sessions.

He completed the BSR programme, which is a 16 session group work based substance use program, designed to reduce offending behaviour and dependent substance use - with an eventual goal of recovery. During this program Tony reported that he had:

  • developing skills in relation to his self-esteem and confidence.
  • acquired numerous skills for successfully managing and coping with cravings/ urges.
  • Received peer support from this group, which was invaluable
  • Become more informed and equipped in relation to recovery.

During his time on BSR, Tony often took the lead during sessions and his outgoing personality was evident for all to see. He commenced opioid substitution treatment, under the supervision of the Clinical Addictions Team, just before the program ended.

When Tony commenced opioid substitution AD:EPT offered him a check in service for encouragement and support during the early stages of treatment. Once he was stabilised on substitution, he accessed specialist treatment/ support in relation to trauma from his childhood.

Pre-release

Prior to release AD:EPT completed a pre-release, focusing on:

  • Harm reduction measures in relation to substance use.
  • Discussion around health risks associated with substance use
  • Development of relapse prevention plan
  • Identify support available.
  • Completion of Naloxone training

Pre-release took place over 4 sessions. Tony stated that the development of a relapse prevention plan made him feel very “safe” and increased his confidence level in relation to maintaining recovery. He identified support structures and recognised these play a very important role in his recovery. He has immediate support from the Community Addictions Team team upon release, is subject to license conditions and has support from Probation Board NI. A referral was also made to WAVE Trauma.

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