Court upholds discrimination finding over Ramadan codeine policy in prison
Somali serial rapist Dahir Ibrahim has won a High Court case against an NHS trust over the way his prescribed codeine was dispensed during Ramadan in prison. The ruling matters because the court upheld a finding that the policy indirectly discriminated against Muslim prisoners, though it did not find breaches of his rights to private life or freedom of religion.
At HMP Birmingham in May 2019, codeine was available only at a supervised medication hatch during morning or afternoon hours, and could not be taken away in Ramadan packs because of concerns about its psychoactive effects. Ibrahim refused it while fasting and said he experienced withdrawal symptoms; the trust argued that overnight dispensing would be impractical and require extra staff. A County Court ruled in his favour in 2024, and the High Court dismissed the trust’s appeal in a judgment issued on 29 September.
- A prisoner won a discrimination case over codeine dispensing during Ramadan.
- The High Court dismissed the NHS trust’s appeal.
- The ruling concerned indirect discrimination, not breaches of religious freedom.
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A court case concerns a prison's medication policy and its effects on Muslim inmates. The case centres on an inmate at a prison in Birmingham who challenged how his prescribed codeine was made available to him.
At the prison, codeine was only dispensable at certain supervised times during the day, and could not be given out in special medication packs for Ramadan, because of concerns about its psychoactive effects. The inmate said this left him unable to take his medicine whilst fasting during Ramadan and caused him withdrawal symptoms. The prison trust argued that changing the policy would be impractical and require additional staffing.
The court's findings have significance beyond this individual case. The ruling established that the policy indirectly discriminated against Muslim prisoners, raising questions about how prisons balance medication management with religious observance.
Both sides, in good faith
The strongest fair case each way — we don't pick a winner.
The case for
The policy prevented Muslim prisoners from taking prescribed medication during fasting hours, causing withdrawal symptoms. The court found this constitutes unlawful indirect discrimination, as a neutral rule that disproportionately burdens religious observance must be justified by demonstrating that proportionate alternatives, such as supervised evening dispensing, are genuinely impractical.
The case against
Codeine has psychoactive effects that raise legitimate security concerns in a prison environment, and limiting supervised dispensing reflects sound medical and operational judgment. The policy applied equally to all prisoners regardless of faith; requiring additional evening staffing to accommodate religious practice could impose unreasonable operational burden, and the prison trust reasonably prioritised institutional security constraints.
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Originally published by Daily Mail as “Somali serial rapist sues NHS over how prescriptions are handed out in jail during Ramadan… and wins”.