This chapter discusses the manifestations of stigma related to problematic drug use in prisons in an attempt to understand how the experience of stigma is mediated by social circumstances, cultural context. It draws on the research conducted by the Centre for Ethnicity and Health on the delivery of prison drug services in England and Wales, with focus on Black and minority ethnic prisoners. Sociologists and criminologists have utilised the concepts of labelling, deviance and stigma in their investigations into the influence of social structure on individual action and identity. The possible explanations for the stigma attached to mental illness have been identified as the perceived dangerousness of the patient, attribution of responsibility for their illness to the patient, poor prognosis and disruption of social interaction with ‘normal’ people. The use of heroin and crack cocaine attracted particular stigma among many prisoners of all ages, but such views were expressed most strongly and most often by Black and minority ethnic inmates.