“It was through the programme that I realized I was sick.”
Mr. Sowah, an ex-prisoner who has been sober for six years, says that he didn’t used to see himself as having a drug use disorder. "I didn’t know anything about addiction, and I thought it was my choice."
Ghana’s prison system, like others worldwide, faces the major challenge of addressing drug supply and distribution. Besides the usual reasons for drug use, prisons around the world may themselves act as triggers in some instances. The challenging conditions and limited resources available in prison settings exacerbate drug use in some instances. Drugs like cannabis, diazepam, and opiates are readily available within the prison walls, an environment which makes it difficult for prisoners, including those who were addicted before they came to prison, to address their drug use disorders.
However, amidst these challenges, the Addiction, Treatment, Rehabilitation, and Recovery (ATRR) programme, implemented by the Ghana Prisons Service and supported by the UN Office on Drugs and Crime (UNODC), offers hope. The programme is open to all prisoners on a voluntary basis and combines various approaches including medical, faith-based, counselling and peer sponsoring. One key model is the group-based session which is run in two phases: the first open to the general population to raise awareness and the second a closed session for participants in the programme to share their experiences, knowledge, struggles and to encourage each other.
Group sessions were particularly useful for Mr Sowah, and being a sponsor and model as a Bible study leader helped him stick to his treatment. "The issue with addicts is, we hardly share,” says Mr Sowah. “But when we did share our stories, we realized that the people know what they are talking about, and they are also going through the same thing, so now we began to open up."
“It has intrigued a lot of the prisoners; it has helped them to find balance in their lives,” says Dr. (Supt.) Lawrence Kofi Acheampong, Forensic Physician and Medical Superintendent of Prisons Hospital, Nsawam. He is one of only two doctors serving a prison population of over 15,000.
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The need for a drug treatment program in Ghana was clear, as a high number of prisoners were found to use drugs in one form or another. In 2019, a joint report by UNODC and the Ghana Aids Commission found that prisoners commonly use cannabis, nicotine, and benzodiazepines, with limited use of methamphetamines, cocaine, tramadol, and heroin.
Nana, another male prisoner, says his drug use disorder started at a young age. With his family wealth and good job, he felt comfortable financing his drug use for a while. Then, he says, his judgment became clouded by the drugs, leading him to quit his job.
"That is how addiction works. You start using, and at a point in time, you feel that working is a waste of time. I saw that I could trade in drugs and make so much money out of it, but this was shallow thinking."
Nana resorted to fraud to keep up with the burden of his addiction. Despite several rehabilitation attempts prior to his incarceration, it was the ATRR programme that helped him make significant progress in his recovery.
With the support of UNODC, in 2023 the government of Ghana expanded the programme from Nsawam to all 46 prisons across the country.
Despite the progress made, challenges remain which affect the efficacy of the ATRR programme. Overcrowding in prisons remains a significant issue, preventing the isolation of those undergoing drug use disorder treatment from the general population. Continuing exposure to drugs within the prison environment hinders recovery efforts.
Additionally, there is a need for better nutrition for those in treatment and recovery. The lack of testing kits for random checks making it difficult to keep up on the progress of prisoners in the treatment program is another challenge that needs to be addressed.
Stigma too is a challenge, both during prison stays and after release. “They call it the mad people’s programme,” participant Michael shares.
“We tease ourselves so that we don’t feel it when they laugh at us,” Nana adds.
Ghana's new Narcotics Control Commission Bill, passed into law in 2023 (Act 1019), marks a significant shift towards a public health-centered and human rights approach to drug policy. This law aligns Ghana closer with the UN System Common Position on Incarceration, which advocates for decriminalizing drug use and reducing interactions between people who use drugs and the criminal justice system. The new law emphasizes non-custodial sentencing measures, which can help decongest overcrowded prisons and break the cycle of poverty exacerbated by incarceration for minor drug-related offences.
Ms. Gloria Essandoh, Director of Prisons in Charge of Health, is hopeful for the future. “I would like to see more initiatives that support harm reduction and drug policies that prioritize public health and human rights,” she says. But she is cautious. “The Service does not have enough staff who are adequately trained to handle drug use disorders.”
While more support is needed, the ATRR programme is an example of how structured and supportive treatment and rehabilitation programs can transform lives. With the support of UNODC and ongoing policy shifts towards a public health and human rights approach, Ghana is making significant progress in addressing drug use and drug use disorders within its prison system.
Today, Mr Sowah is an advocate for the public health approach to drug use and an ambassador for the ATRR programme. Nana and Mike look forward to following in his footsteps on release, and plan to support people in their communities with drug use disorders. “I want to educate myself,” Michael says, “so I can work at the rehab centre to educate other suffering addicts.”
Find out more about UNODC’s work on prison and penal reform
Read the World Drug Report 2024 here.
With thanks to the donor, the Bureau of International Narcotics and Law Enforcement Affairs in the U.S. Department of State.
