Living with addiction in the shadow of punishment: a qualitative study of prison drug use and harm reduction in Iceland.
- 1Landspitali University Hospital, Reykjavik, Iceland.
- 2Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland.
Abstract
This qualitative study explored how people with experience of imprisonment and injecting drug use in Iceland understand drug-related harm in prison and the role of harm reduction. It adds qualitative evidence from a small prison system where social proximity, limited anonymity and concerns about trust and confidentiality shape understandings of harm, safety and support. Six participants aged 25-35 were interviewed, and the data were analysed thematically within an interpretive description framework. Participants described prison drug use as continuing dependence under hidden, unsafe and degrading conditions. Four themes were identified: (a) You always find a way; (b) Pushed into hiding; (c) Deepened suffering and shame; and (d) Seeking safety under surveillance. Together, these form the overarching interpretation, "Living with addiction in the shadow of punishment". Harm reduction went beyond access to sterile equipment. It was seen as humane, health-oriented care that could reduce injury and preserve dignity. The findings suggest that unmet harm reduction needs in prison may increase risk by pushing drug use further into secrecy and distancing people from care. In Iceland, where prisons are few, social worlds overlap and anonymity is limited, participants identified trust, confidentiality and independence from punitive authority as key conditions for harm reduction.
Related
- Patient experiences of benzodiazepine tapering: a qualitative study of treatment in addiction care.
- Mental Health and Addiction Care Professionals' Views on Artificial Intelligence Integration in Oman: A Descriptive Qualitative Study.
- Antiretroviral therapy, perceived health, and fertility decision-making among people living with HIV: a qualitative study at a district antiretroviral therapy clinic in the Ashanti Region, Ghana
- Participant Characteristics Associated With Loneliness Reduction During a Digital Social Robot Intervention Among Older Adults Living Alone in Japan: Secondary Analysis of a Randomized Controlled Trial
- COVID-19-related disruptions and adaptations to HIV service delivery in Rakai, Uganda: A qualitative study among virologically unsuppressed people living with HIV and HIV care providers
BibTeX
@article{yeoman2026living,
title = {{Living with addiction in the shadow of punishment: a qualitative study of prison drug use and harm reduction in Iceland.}},
author = {Margrét Dís Yeoman and Helga Sif Fridjónsdóttir and Marianne Elisabeth Klinke},
journal = {International journal of circumpolar health},
year = {2026},
month = oct,
doi = {10.1080/22423982.2026.2741750},
url = {https://europepmc.org/article/MED/42853236},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Living with addiction in the shadow of punishment: a qualitative study of prison drug use and harm reduction in Iceland.
AU - Margrét Dís Yeoman
AU - Helga Sif Fridjónsdóttir
AU - Marianne Elisabeth Klinke
PY - 2026
DA - 2026/10/09
JO - International journal of circumpolar health
DO - 10.1080/22423982.2026.2741750
UR - https://europepmc.org/article/MED/42853236
AB - This qualitative study explored how people with experience of imprisonment and injecting drug use in Iceland understand drug-related harm in prison and the role of harm reduction. It adds qualitative evidence from a small prison system where social proximity, limited anonymity and concerns about trust and confidentiality shape understandings of harm, safety and support. Six participants aged 25-35 were interviewed, and the data were analysed thematically within an interpretive description framework. Participants described prison drug use as continuing dependence under hidden, unsafe and degrading conditions. Four themes were identified: (a) You always find a way; (b) Pushed into hiding; (c) Deepened suffering and shame; and (d) Seeking safety under surveillance. Together, these form the overarching interpretation, "Living with addiction in the shadow of punishment". Harm reduction went beyond access to sterile equipment. It was seen as humane, health-oriented care that could reduce injury and preserve dignity. The findings suggest that unmet harm reduction needs in prison may increase risk by pushing drug use further into secrecy and distancing people from care. In Iceland, where prisons are few, social worlds overlap and anonymity is limited, participants identified trust, confidentiality and independence from punitive authority as key conditions for harm reduction.
SN - 1239-9736
SN - 2242-3982
ER -