Background to the report

In April 2025, approximately 40,000 people in prisons in England and Wales (50%) had an identified drug problem. Misuse of illicit drugs by people in prison creates or exacerbates risks to their health, well-being and personal safety.

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Between December 2022 and December 2024, the Prisons and Probation Ombudsman investigated 833 deaths, of which 136 (16%) were drug-related.

Conveyance, supply and use of illicit drugs also increase risks to the safety and stability of the prison regime. Availability of drugs inside prisons creates an illicit economy that can fuel debt, which can lead to assault, extortion or self-harm. Prisoners who are using illicit drugs often reoffend after leaving prison.

Scope of the report

This report focuses on how the prison and health services are using public funds to tackle drug harms in prisons. It examines:

  • how well the Ministry of Justice (MoJ), HMPPS, Department of Health & Social Care (DHSC), NHSE and wider government understand the scale and nature of drug harms in prisons
  • the funding available for HMPPS and NHSE to tackle drug harms in prisons, and how resources are prioritised
  • how effectively resources have been used and how well the prison and health services work together

Video summary

Jenny George, the report’s director, summarises our findings.

Conclusions

Illicit drugs in prison pose significant challenges to successful offender rehabilitation, prisoners’ physical and mental health, the safety of staff and prisoners, and the stability of the prison environment. Tackling drug harms in prison involves restricting the supply of drugs into prison and supporting people in prison to reduce their drug misuse, both through drug treatment and recovery services and by creating a prison environment that incentivises sustainable drug-free living.

This works best where there is good liaison between HMPPS and health services, with a shared understanding of need and well-aligned incentives for staff to support prisoners’ treatment and recovery. However, in a context of wider pressures on prison capacity, prison staff reported they lacked the influence needed to improve health-related services, while NHS staff did not always feel sufficiently involved in decisions on prison operations and were reliant on prison staff to enable those services to be delivered safely.

It is impractical to calculate a precise cost of tackling drug harms in prisons, making it impossible to assess overall value for money of drug treatment and recovery. However, HMPPS significantly underspent budgets intended for security improvements and initiatives to support prisoners. We also heard prison staff voice their frustration at the slow pace of urgent repairs and improvements.

Meanwhile, our estimate is that drug treatment funding has decreased in real terms. Better performance information, continued willingness to innovate, continued learning from robust evaluation and, above all, a renewed commitment to cross-government partnership working will be essential for the government to direct resources to where they will have greatest impact.

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Publication details

Press release

View press release (4 Feb 2026)

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