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A recent research article from the PriSUD project shows a significantly higher prevalence of mental disorders among individuals in preventive detention compared to other prisoners. The study, published in BMC Psychiatry, highlights a critical need for tailored health services for this group. First author John Todd-Kvam and his colleagues have conducted a comprehensive registry study mapping the prevalence and patterns of mental disorders among individuals in preventive detention in Norway over a 13-year period. The results are clear: this group is significantly more vulnerable to mental health challenges than other prisoners, even when compared to those sentenced for similar serious offenses. The study, titled "Prevalence and patterns of mental health disorders in long-term preventive detention: a 13-year national cohort study," sheds light on a vulnerable group that often has complex and severe disorders. The findings point to a great need to strengthen mental health services for those sentenced to preventive detention to ensure adequate treatment and follow-up. The data for the study was sourced from the PriSUD project and the national nPRIS cohort, which is a registry linkage containing information on everyone who has been incarcerated in Norwegian prisons. This provides a unique and robust basis for analysing health challenges in this population. The article is the result of a broad academic collaboration between researchers from several institutions including the Department of Mental Health, Norwegian University of Science and Technology in Trondheim, the Norwegian Centre for Addiction Research (SERAF) at the University of Oslo, the Division of Mental Health and Addiction at Oslo University Hospital, the University College of Norwegian Correctional Service (KRUS), and the Centre for Research and Education in Security, Prison and Forensic Psychiatry (SIFER). This interdisciplinary collaboration has been crucial for shedding light on a complex and important topic from multiple perspectives.

Great news! PriSUD PhD fellow Rose Lunde submitted her thesis, titled "(P)rehab and Punishment: Drug Treatment, Therapeutic Intervention and Hybrid Penality in Prison," for assessment on April 18th. The work is based on extensive qualitative data collected by Rose herself and will be evaluated for the PhD degree at the Department of Criminology and Sociology of Law, Faculty of Law, University of Oslo (UiO). Our warmest congratulations! Picture by Erwan Hesry | Unsplash ( https://unsplash.com/@erwanhesry ) Furthermore, the third article from her thesis has recently been published in the journal Incarceration , with the title "Prisonlike or prison-lite? Drug recovery units and penal hybridity in Norway." In the article, Rose explores how drug recovery units in Norwegian prisons are perceived as safer, more therapeutically beneficial, and more privileged environments than other prison wards, while at the same time being more challenging, punitive, and at times more painful places to be. The work is based on ethnographic fieldwork and 55 interviews (33 incarcerated individuals and 22 staff members).

In a new publication in Scientific Reports , Vegard Svendsen and co-authors investigated the link between substance use disorders, mental illness, and recidivism in a large, national study. The study followed all women released from Norwegian prisons between 2011 and 2019 for a period of two years post-release. The article shows that women with both severe mental illness and substance use disorders, or those with multiple different substance use disorders, have a higher risk of reoffending after their release. The researchers linked data from a study on formerly incarcerated individuals with data from various national health and crime registries. By controlling for other known risk factors, they examined the risk of violent crime, drug-related crime, and other types of offenses among women with different types of mental and substance use disorders. They compared these groups to a reference group of women with no such history. The results clearly showed that women who had both a severe mental illness and a substance use disorder, women with substance use disorders combined with other mental illnesses, and women with multiple different substance use disorders all had a significantly higher risk of committing both violent and drug-related offenses post-release. In contrast, women with only a severe mental illness had an increased risk for other types of crime, but not necessarily for violent or drug-related offenses. The study concludes that women with a history of severe mental illness or complex substance use disorders have an increased vulnerability to relapsing into criminal behavior after incarceration. This underscores the importance of robust follow-up and tailored support for this group, both during and after their sentences, to reduce the risk of recidivism. Citation: Vegard G. Svendsen, Marianne R. Stavseth, Torbjørn Skardhamar, Ingrid A. Havnes, Anne Bukten. ”Substance use disorders, severe mental illness and risk of reoffending among women released from prison: a national cohort study”. Scientific Reports  (2025), Vol. 15, Issue 1, https://doi.org/10.1038/s41598-025-00215-y

There has been much interest in the first results from the WOMPRIS project: the first article addresses current issues and has received coverage in several media outlets. The handling of women in prison with mental disorders by the Correctional Services has been a prominent topic in public debate in Norway, especially in the past year. These are subjects that intersect with several of the focus areas in the PriSUD project. The WOMPRIS group, which specifically addresses health challenges in the female part of the prison population, recently published their first article ("Psychiatric morbidity among women in Norwegian prisons, 2010–2019") in the journal BMC Psychiatry. The article, among other findings, indicates that the prevalence of psychiatric diagnoses is significantly higher among female inmates compared to males and that the proportion of female inmates entering prison with an active mental disorder has increased considerably since 2010. "With this article, we finally have good and up-to-date statistics on the prevalence of mental disorders among women incarcerated in Norwegian prisons," says Vegard Svendsen, co-author and representative of the WOMPRIS project. The results of the study are also described in the ombudsman's report [Norwegian only] on Bredtveit Prison. Based on the findings from this report, the project group has written an opinion piece on the topic, which was published on Dagsavisen's website [Norwegian only] and in their e-newspaper (May 26, 2023). "It's great that the study has received so much publicity and that it could contribute to the debate on conditions at Bredtveit Prison," says Svendsen. "It shows that the researcher's voice and the work we do in the PriSUD project can play an active role in raising and highlighting important, current societal issues."

Despite a significant and increasing proportion of persons arriving prison as patients in opioid agonist treatment (OAT), there is little knowledge about this vulnerable group. A significant proportion of individuals arrive in prison with challenges related to substance use and mental disorders. In a recent study from the PriSUD project at SERAF, it was revealed that people who serve sentences while in OAT treatment face significant health challenges: more than 90% have other substance use disorders, and over 60% have other mental disorders. The study is based on all individuals who were incarcerated during the period from 2010 to 2019, encompassing a total of 51,148 individuals. Throughout the observation period, 14% of the prison population had opioid use disorder, and of these, 64% received OAT treatment. As the study includes a 10-year follow-up, it was also observed that the proportion of individuals receiving OAT treatment increased significantly, from 35.7% in 2010 to 70.9% in 2019. While it is positive that more individuals receive OAT treatment during their sentences, it is crucial for the Correctional Services and the healthcare departments within the prisons to be aware that this is an extra vulnerable group of OAT patients. It is essential that those serving sentences with OAT can also receive treatment for other substance use disorders and other mental disorders. The study has been published in Drug and Alcohol Dependence: https://pubmed.ncbi.nlm.nih.gov/37515826/

Twice a year, Oslo University Hospital awards a prize to just six outstanding research articles with key authors from the hospital. In December, the PriSUD project had the pleasure of receiving this award for the article "The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16)"where we find high mortality after release among those who have been incarcerated in a high security prison. The article was written by Anne Bukten, Ingeborg Skjærvø and Marianne R. Stavseth. The prize was NOK 50 000, intended to fund further research.

Hilde Pape, Philipp Lobmaier, Anne Bukten. An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT). A prison population study. Drug and Alcohol Dependence Reports, Volume 3, 2022. https://doi.org/10.1016/j.dadr.2022.100043 Background The eleven-item Drug Use Disorder Identification Test (DUDIT) is a recommended screening tool, but its length may impede its use in prison intake assessments. Hence, we examined the performance of eight brief DUDIT screeners against the full DUDIT, employing a sample of male inmates. Methods Our study included male participants in the Norwegian Offender Mental Health and Addiction (NorMA) study who reported pre-prison drug use and who had been incarcerated three months or less (n = 251). We performed receiver operating characteristic curve (ROC) analyses and estimated the area under the curve (AUROC) to assess the performance of DUDIT-C (four drug consumption items) and five-item versions that consisted of DUDIT-C and one additional item. Results Almost all (95%) screened positive on the full DUDIT (scores ≥6) and 35% had scores that were indicative of drug dependence (scores ≥25). The DUDIT-C performed very well in detecting likely dependence (AUROC=0.950), but some of the five-item versions performed significantly better. Of these, the DUDIT-C + item 5 (craving) had the highest AUROC (0.097). A cut-point of ≥9 on the DUDIT-C and ≥11 on the DUDIT-C + item 5 identified virtually all (98% and 97%, respectively) cases of likely dependence, with a specificity of 73% and 83%, respectively. At these cut-points, the occurrence of false positives was modest (15% and 10%, respectively) and only 4–5% were false negatives. Conclusions The DUDIT-C was highly effective in detecting likely drug dependence (according to the full DUDIT), but some combinations of DUDIT-C and one additional item performed better.

The PriSUD project is a large research project that aims to improve health among inmates with substance use disorders. But how do you do that, and why is it so important? In order to explain this complex project in a simple way, we got the Danish research dissemination company madeclear to create a so-called 'explainer'; a film that shows what the PriSUD project is all about. Watch it here! made by madeclear.dk

Bukten, Anne; Skjærvø, Ingeborg; Stavseth, Marianne Riksheim. The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16). The Lancet Public Health, Volume 7, Issue 7, 2022, Pages e583-e592, ISSN 2468-2667, https://doi.org/10.1016/S2468-2667(22)00107-4. Background Incarceration might contribute to increased mortality in an already marginalised population. A better understanding of the prison-related factors that are associated with mortality is important for preventing the negative health consequences of incarceration. We aimed to investigate all-cause and cause-specific mortality following release from high-security and low-security prisons. Methods In this retrospective national cohort study, we used data from the Norwegian Prison Release study (nPRIS), which includes complete national register data for 96 859 individuals from the Norwegian Prison Register linked to the Norwegian Cause of Death Register from Jan 1, 2000, to Dec 31, 2016. The study cohort included all people in Norway released from a high-security or low-security prison unit. Cause of death was categorised into internal causes (infectious, cancerous, endocrine, circulatory, respiratory, digestive, nervous system diseases, and mental health disorders) and external causes (accidents, suicides, and homicides) according to the 10th revision of the International Classification of Diseases. We calculated crude mortality rates (CMR) and estimated Cox proportional-hazards models. Findings There were 151 790 releases in the study period (68·4% from low-security and 31·6% from high-security prisons) from 91 963 individuals. The overall CMR was 854·4 [95% CI 834·7–874·2] per 100 000 person-years (436·2 [422·1–450·3] per 100 000 person-years for internal causes and 358·3 [345·5–371·1] per 100 000 person-years for external causes). The overall post-release mortality rate was higher in those released from high-security prisons (1142·5 [95% CI 1102·6–1182·5] per 100 000 person-years) than in those released from low-security prisons (714·6 [692·6–736·6] per 100 000 person-years). Our results suggest an association between release from high-security prisons and elevated mortality due to both external causes (adjusted hazard ratio [aHR] 1·75 [95% CI 1·60–1·91]) and internal causes (1·45 [1·33–1·59]), compared to release from low-security prisons. Interpretation Imprisonment and the post-release period can be an important point for public health interventions. Particular attention to health is warranted for individuals incarcerated in and released from high-security prisons. The potential impact of both individual-level characteristics of people incarcerated in high-security facilities, and of the prison environment itself, on mortality outcomes, should be investigated further.

Suvi Virtanen has been awarded a postdoctoral fellowship of 2,4 million SEK by the Swedish Research Council for Health, Working Life and Welfare (Forte). In her project “Evaluating effectiveness of substance misuse and addiction treatment in correctional services in Sweden” she will combine the use of nationwide register data with quasi-experimental methods to evaluate whether currently offered substance abuse treatments are effective in reducing recidivism, overdoses, and mortality. One of the project aims is to investigate the effectiveness of “contract treatment” (kontraktsvård), which is offered as an alternative sanction to prison for individuals whose committed crime was closely linked with substance misuse problems.

In collaboration with the entire PriSUD project group, we have published the protocol of the PriSUD project. In the paper, you can read about what the PriSUD project is, what our ambitions are in the years to come, and why it is so important. The article is open access and can be read and downloaded for free here

Bukten A, Lokdam NT, Skjærvø I, Ugelvik T, Skurtveit S, Gabrhelík R, Skardhamar T, Lund IO, Havnes IA, Rognli EB, Chang Z, Fazel S, Friestad C, Hesse M, Lothe J, Ploeg G, Dirkzwager AJE, Clausen T, Tjagvad C, Stavseth MR. PriSUD-Nordic—Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022;11(3):e35182. doi: 10.2196/35182 Background: A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research. Objective: The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison. Methods: PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release. Results: PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages. Conclusions: PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population.