Though a small minority of participants reported having purchased drugs online in the preceding six months, these appeared to be a more 'entrenched' group of consumers, with more diverse substance use and rates of criminal activity. For consumers in the current sample reporting recent dark net usage, country borders are now less of a significant barrier to purchase and there is a wider range of substances available than ever before.
Balancing the preference of many patients to cease OST prior to release against patient safety post-release is a substantial challenge for opioid treatment providers in correctional settings. These findings indicate the need for research on how best to attract and retain opioid-dependent prisoners in treatment and the need to provide other interventions for prisoners uninterested in post-release OST, such as take-home naloxone. [Larney S, Zador D, Sindicich N, Dolan K. A qualitative study of reasons for seeking and ceasing opioid substitution treatment in prisons in New South Wales, Australia. Drug Alcohol Rev 2017;36:305-310].
Findings highlight the challenge of mental health problems for homeless PWID. Our results demonstrate that further research that evaluates outcomes of housing programs accommodating PWID, particularly those with comorbid mental health disorders, is warranted. Results also emphasise the need to better utilise integrated models of outreach care that co-manage housing and mental health needs.
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