Structural violence, decolonization and harm reduction in prisons: a critical perspective on opioid use disorders, gender and race.

Substance use remains highly prevalent among prison populations. The war on drugs represents an ethical failure that has not achieved its intended goals. Redirecting resources toward reducing inequality and improving living conditions for citizens could prove more effective in addressing substance use than punitive approaches. Scientific literature consistently shows that prisoners are denied access to healthcare and face discrimination based on race, class, and gender. Continued efforts are needed to raise awareness about the benefits of opioid substitution treatment and needle exchange programs, which help reduce mortality by lowering the risk of overdose after release. Combating corruption, both inside and outside prisons, must be considered a priority. If the prevalence of drug use among incarcerated populations continues to rise, why has there been no reform of a policy long recognized as ineffective and profoundly harmful to prisoners? Who benefits from this?