title: Cannabis use in a Swiss male prison: qualitative study exploring detainees' and staffs' perspectives.
abstract: BACKGROUND
  Several studies suggest a high prevalence of cannabis use before and during imprisonment, but subjective perspectives of detainees and staff towards its use in prison are lacking. This issue was explored in the framework of an observational study addressing tobacco use in three Swiss prisons in 2009 and 2010 that involved multiple strands (quantitative and qualitative components). This article presents qualitative data on cannabis use collected in one of the settings.
  
  
  METHODS
  We used in-depth semi-structured interviews with both detainees and staff to explore their attitudes towards cannabis in one post-trial male Swiss prison. We performed specific coding and thematic analysis for cannabis with the support of ATLAS.ti, compared detainees' and staff's opinions, and considered the results with regard to drug policy in prison in general.
  
  
  RESULTS
  58 participants (31 male offenders, mean age 35 years, and 27 prison staff, mean age 46 years, 33% female) were interviewed. Detainees estimated the current use of cannabis use to be as high as 80%, and staff 50%. Participants showed similar opinions on effects of cannabis use that were described both at individual and institutional levels: analgesic, calming, self-help to go through the prison experience, relieve stress, facilitate sleep, prevent violence, and social pacifier. They also mentioned negative consequences of cannabis use (sleepiness, decreased perception of danger and social isolation), and dissatisfaction regarding the ongoing ambiguous situation where cannabis is forbidden but detection in the urine was not sanctioned. However, the introduction of a more restrictive regulation induced fear of violence, increased trafficking and a shift to other drug use.
  
  
  CONCLUSIONS
  Although illegal, cannabis use is clearly involved in daily life in prison. A clearer and comprehensive policy addressing cannabis is needed, including appropriate measures tailored to individual users. To sustain a calm and safe environment in prison, means other than substance or medication use are required.
authors.affiliation: University Centre of Legal Medicine of Geneva and Lausanne, 9, av. de Champel, 1211 Geneva 4, Switzerland. Electronic address: Catherine.Ritter@unige.ch.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ritter
authors.affiliation: Unit for Dependency in Primary Care at the Department of Community Health and Primary Care, University Hospitals of Geneva, Faculty of Medicine, 1211 Geneva 4, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Broers
authors.affiliation: Head of the Institute of Biomedical Ethics at the University of Basel, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland.
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Elger
mesh_terms: D000328:Adult; D064423:Drug Trafficking / Q000517:prevention & control; D004335:Drug and Narcotic Control; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000523:psychology*; D008385:Marijuana Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence / Q000523:psychology*; D008875:Middle Aged; D010465:Perception; D011329:Prisoners / Q000331:legislation & jurisprudence / Q000523:psychology*; D011330:Prisons / Q000331:legislation & jurisprudence; D012919:Social Behavior; D012927:Social Control, Informal; D013557:Switzerland / Q000453:epidemiology; D014754:Violence / Q000517:prevention & control; D000078329:Workforce
keywords: Cannabis; Detainees; Drug policy; Harm reduction; Prison; Qualitative