and measures of harm reduction have been described in detail in Chapter 3 on the prevention of spread of HIV/Aids and hepatitis B/C in prisons. Treatment Notwithstanding the importance of frst exhausting all possible alternatives to imprisonment for drug‑dependent ofenders, as emphasised above, forced stabilisation during imprisonment can and should be used to ofer treatment that, due to their chaotic lifestyle, has not been earlier accessible for them. Successful treatment needs the full co‑operation of the patient. Compulsory treatment of mentally competent drug‑dependent patients, although still prevailing in the penal legislation of several countries, is both medically and ethically more than questionable. Drug addiction is a chronic disease prone to recurrences that need long‑term treatment, like any other chronic disease. As outlined above, a major proportion of substance‑dependent patients sufer from additional psychiatric co‑morbidities that need to be diagnosed and treated properly. It has been clearly shown that pharmacological treat‑ ment of co‑morbid depressive or schizophrenic disorders is efcacious in the treatment of substance dependency.11 For pharmacological treatment of other psychiatric conditions, the prescription of benzodiazepines in prison should be handled with great caution and taking them should be controlled visually because of the high risk of diversion, as in the case of prescribed drugs in opioid‑substitution treatment. As the treatment goal of abstinence in opiate addiction is hardly ever achieved in the short run, the orientation of most current treatment concepts has shifted from abstinence strategies to acceptance of drug use alongside harm‑reducing treatments which try to stabilise the psychosocial situation of the drug‑ dependent client, reduce criminality, keep the patient alive and in therapeutic terms reduce adverse health consequences. This works best in combination with oral opioid substitution. In line with the multifactorial aetiology of substance dependency, there is a wide range of psychological and psychosocial treatment concepts, from various psychoanalytic techniques such as Gestalt therapy to cognitive behavioural therapies such as contingency management, relapse prevention and motiv‑ ational enhancement techniques. The choice of the best possible psychosocial 11. WHO: Neuroscience of psychoactive substance use and dependence (Geneva 2004). Prison health care and medical ethics Page 76