‘Keeping a lid on it’: Exploring ‘problematisations’ of prescribed medication in prisons in the UK

Restrictive prescribing practices are recommended as a solution to the ‘problem’ of diversion and misuse of prescribed medication. Prescribers are advised to consider de-prescribing, non-pharmacological treatments and alternative prescriptions with less diversionary potential. They are represented as responsible for the ‘problems’ that prescribed medication bring to prisons. The guidance is underpinned by the assumption that prescribers lack experience, knowledge and skills in prison settings. People serving prison sentences are assumed to be ‘untrustworthy’ and their symptoms treated with suspicion. This representation of the ‘problem’ has a number of effects including the possibility of increasing drug-related harm, damaging the patient-doctor relationship and disengagement from healthcare services.