The assessment of prison services and management was done with reference to current Council of Europe and World Health Organization guidelines as well as the national policies developed for each country. The research encompassed 2 sample prisons in each of the 10 countries. There is evidence of an increasing number of addictive drug users in the 10 countries, both in the community and in prisons, bringing with it a higher prevalence of hepatitis and HIV as well as other drug-related health risks. Although efforts at health care services and drug treatment are present, there is little standardization in the approach being used to design and deliver services. The author discusses the importance of providing harm-reduction information to inmates about drugs and communicable diseases, the availability of condoms, bleach for cleaning needles, and needle exchange, and the availability of both long-term and short-term substitution treatment (methadone maintenance). Other key issues addressed are prison overcrowding, the availability of inmate work, bullying, and suicide and self-harming. Multidisciplinary efforts are needed if all dimensions of these problems are to be addressed. Such an effort was absent in all the sample prisons. 10 references