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The Prison Social Milieu, Cell Overcrowding and Correlates to Inmate Substance Use: A Study of Drug Using Inmates in Three Mexican Prisons

Madu, Nneka Janavive (2013)
Master's Thesis (59 pages)
Committee Chair / Thesis Adviser: Stephenson, Robert
Committee Members:
Research Fields: Health Sciences, Public Health; Sociology, Criminology and Penology
Partnering Agencies: International Non-governmental organization (e.g., CARE, Inc.)
Keywords: prison; drugs
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url:


Background: Individuals with a history of incarceration experience higher rates of infectious and chronic diseases, mental illness and trauma than the general population. Inmate misconduct, particularly drug infractions, is a reliable correlate for these negative inmate health outcomes. Very little research has explored the incarceration experience as a predictor of inmate substance use.

Objectives: (1) Identify the prevalence, type and frequency of drug use in three Mexico City prisons, (2) identify the aspects of prison social life that have a significant association with the increased likelihood of inmates reporting drug use, and (3) identify whether overcrowding is associated with inmate substance use.

Methods: Four logistic regression models were fitted for four outcomes of interest: any drug usage; heavy use of any drug; heavy marijuana usage; and heavy usage of multiple drugs. Covariates of interest were related to the prison experience and overcrowding.

Results: 350 male inmates were included in this study. Nearly 84% of inmates reported any drug use in prison. Respondents that reported having secondary education (OR: 0.3, 95% CI: 0.1-0.8) and respondents that reported being married/ in a committed relationship (OR: 0.4, 95% CI: 0.1-0.99) were less likely to report any drug use. Inmates with registered conjugal visitors were less likely to report any drug use (OR: 0.5, 95% CI: 0.2-0.9), heavy drug use of any kind (OR: 0.5, 95% CI: 0.3-0.9), and heavy marijuana use (OR: 0.6, 95% CI: 0.3-0.97). Those employed in prison were less likely to report any drug use (OR: 0.4, 95% CI: 0.2-0.9). Alcohol users were more likely to report the heavy use of any drug (OR: 2.8, 95% CI: 1.2-6.6), heavy marijuana use (OR: 3.0, 95% CI: 1.3-7.2), and the heavy use of multiple drugs (OR: 5.9, 95% CI: 2.1-16.1).

Discussion: The results indicate that there is a high prevalence of substance use among inmates in Mexican City prisons. Prison programming in Mexico must aggressively explore avenues to curtail use within correctional facilities. In addition to drug treatment programs, encouraging inmate participation in activities that provide avenues for positive social reinforcement (e.g. intimate partner visits and vocational programs) may provide a buffer to the negative social pressures within prison that encourage substance use.

Table of Contents

Table of Contents -- Chapter 1: Introduction -- 1.1 Study Setting...1 -- 1.2 The Problem...3 -- 1.3 Thesis Objectives and Aims...4 -- 1.4 Significance of this Research...5 -- Chapter 2: Literature Review -- 2.1 Substance Use and Abuse in Prison...6 -- 2.2 Rehabilitative Programs and Inmate Adjustment...14 -- 2.3 Overcrowding and Prisoner Misconduct...21 -- 2.4 Summary of the Literature...25 -- Chapter 3: Study Design and Methodology -- 3.1 Study Design...26 -- 3.2 Methodology and Analysis...27 -- Chapter 4: Study Results -- 4.1 Prevalence of Drug Use...30 -- 4.2 Significant Correlations...30 -- 4.3 Significant Adjusted Odds Ratios...31 -- Chapter 5: Discussion and Conclusions -- 5.1 High Prevalence of Non-Injecting Drug Use...33 -- 5.2 The Prison Experience and Inmate Drug Use...35 -- 5.3 Overcrowding and Inmate Drug Use...39 -- 5.4 Limitations of this Study...39 -- 5.5 Recommendations for Future Research...41 -- 5.6 Public Health Recommendations...42 -- References...44 -- Tables and Figures -- Fig. 1. Percentage of Inmates Reporting Any Drug Use in Prison...49 -- Fig. 2. Percentage of Inmates Reporting Heavy Drug Use in Prison...49 -- Fig. 3. Frequency Distribution of Correlates...50 -- Fig. 4. Unadjusted Odds Ratios...51 -- Fig. 5. Adjusted Odds Ratios...51


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