Biopsychosocial and Structural Determinants of Chemical Addictions in Prison Settings
Iskandarov R.R. Biopsychosocial and structural determinants of chemical addictions in prison settings. Penitentiary Science, 2025, vol. 19, no. 2 (70), pp. 189–199. doi 10.46741/2686-9764.2025.70.2.009.
Substance use disorders among prisoners are a multi-level problem caused by the interaction of neurobiological, psychological and social factors. The problem of addiction among persons in places of imprisonment is widespread and has a significant impact on both the individuals themselves and the prison system as a whole. High recidivism rates among prisoners with addictions and low efficiency of traditional approaches to rehabilitation require in-depth interdisciplinary analysis. Numerous studies indicate high levels of chronic stress experienced by prisoners, which necessitates consideration of the relationship between chronic stress and maintenance of addiction in this population. High comorbidity of addiction and incarceration necessitates a deeper understanding of the underlying factors, such as stress, to develop effective intervention strategies. Purpose: to study mechanisms of addiction formation and maintenance in the penitentiary system, analyze the influence of chronic stress on neurochemical processes, cognitive-emotional patterns and social determinants, to substantiate the key importance of chronic stress compared to other factors in maintaining addiction, and to develop expanded recommendations for rehabilitation. Methods: an in-depth review and analysis of current scientific publications containing empirical data on the prevalence and impact of chronic stress, its relationship with addiction in convicts, and the effectiveness of various rehabilitation approaches was conducted. Results: it is revealed that prison conditions (sensory deprivation, limited autonomy, harsh conditions, and violence) provoke chronic stress in convicts, which aggravates neurobiological disorders (dysfunction of the dopamine system, hypercortisolemia, and suppression of neurogenesis) and epigenetic changes associated with these disorders. Chronic stress is a key factor in the maintenance and relapse of addiction, provoking cravings and contributing to the use of psychoactive substances as a means of self-medication. Psychological factors (learned helplessness, distorted time perspective, and emotional dysregulation) and social risks (stigmatization, isolation, and lack of reintegration programs) closely interact with stress, forming a cycle of maladaptation. The effectiveness of complex strategies combining psychological interventions (cognitive behavioral therapy, mindfulness therapy), social support (reintegration programs, family involvement, and mentoring) and, if necessary, pharmacotherapy is confirmed. Conclusion: chronic stress plays a key role in maintaining addiction in convicts. Optimization of rehabilitation requires the integration of neuroscientific data, psychocorrectional methods (cognitive behavioral therapy, mindfulness therapy, and a trauma-informed approach) and socio-environmental approaches (reintegration programs, family support, mentors, and social workers). Promising are complex programs aimed at reducing allostatic load, developing coping strategies, restoring neuroplasticity and ensuring continuity of support after release.
Keywords: chemical dependencies; convicts; penal system; chronic stress; rehabilitation; recidivism; psychological interventions; social support.
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