The compulsion of dependent drug users is taken advantage of by the drugs market, both the drug market for legally accepted drugs (alcohol, tobacco) and, to a much greater extent, the black market for illegal drugs, with adverse social consequences. Illegality of psychoactive drugs is clearly in the interest of traders and dealers because of the lucrative proft margins that allow traders and dealer to make big money quickly and drive substance‑dependent individuals, often already socially disadvantaged, into debt, poverty, social isolation, prostitution, criminality and prison. In view of these negative consequences of substance dependency and the rising number of substance‑dependent patients in many societies, despite the “war on drugs” and the chronic nature of the disorder, the importance of effective harm‑reduction measures, as outlined in Chapter 3 on the prevention of spread of HIV/Aids and hepatitis B and C in prisons, should be emphasised. 5.3 Medical management of drug‑addicted prisoners As mentioned (see above, Epidemiological background), up to 30% of pris‑ oners have a history of problematic and/or injecting drug use and it can be estimated that a major proportion of them fulfl the diagnostic criteria for drug dependency or addiction. In order to meet their health‑care needs, health‑care professionals in prison must identify them during the medical examination on admission, be aware of health emergencies that might occur to these individuals, pay due attention to their particular vulnerability in prison, look for the availability of harm‑reduction measures in prison, provide appropriate treatment of drug dependency and arrange in good time their aftercare upon release. The early identifcation by health‑care professionals of drug‑dependent ofenders during the medical examination at admission is of particular impor‑ tance in order to be prepared for the treatment of and support in withdrawal syndromes and for suicide‑risk assessment, problems that typically arise shortly after imprisonment. In addition, as was pointed out in the chapter on the medical examination at admission, this opportunity should be used to deliver information and education on blood‑borne infections to drug‑ dependent ofenders and to invite them to participate in voluntary confdential counselling and testing for HIV and viral hepatitis. Medical emergencies in drug‑dependent persons include acute withdrawal conditions and, which also occurs in prison, acute drug intoxication. Withdrawal Prison health care and medical ethics Page 74