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Prison sentences are arguably a useful format for providing treatment for substance use disorders in jurisdictions where criminal justice systems have the resources and will to lay the necessary groundwork; in that prisoners may be more ‘accessible’ both practically and psychologically for change and adoption of new habits, treatment providers may also be more accessible to people once entering prison than outside of it. However, it is worth asking what the prison context itself does to the provision and experience of treatment interventions. Based on 55 interviews with prisoners with a history of drug use and prison staff in Norwegian prisons, this study examines how logics of treatment and logics of punishment are experienced as not only conflicting with, but also complementing one another. Prisoners were shown to have different preferences for the levels of punitiveness, or strictness, in the treatment programs available in high-security prisons; whilst both staff and prisoners expressed difficulty navigating risk, trust and progress in drug treatment while operating within the constrains of the prison.