Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff

Gjersing, Linn; Butler, Tony; Caplehorn, John R. M.; Belcher, Josephine; Matthews, Roger

doi:10.1080/09595230701499118

Cited by 24 publications

(21 citation statements)

References 20 publications

(46 reference statements)

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“…The perception that WP-DI, though fraught with extraordinary risks is nevertheless inevitable, points to an imbalance in resources for HIV prevention and assets promoting drug use that perpetuates high-risk WP-DI and underpins prisoners' decisions about drug treatment and HIV care. Prison-based MMT has consistently been documented to reduce WP-DI and improve overall health with few negative consequences (Stallwitz and Stover, 2007) Yet, entrenched negative attitudes about MMT among prisoners (Bachireddy et al, 2011; Zamani et al, 2010), prison personnel (Gjersing et al, 2007; Polonsky et al, 2015) and family members (Liu et al, 2013), and fear of being ostracized by other prisoners still influence drug treatment decisions among opioid-dependent prisoners. Compounding these are concerns about “mixing” of methadone with life-preserving ART (Altice et al, 2001), which are in part accurate since most first-line ART in Indonesia includes a non-nucleoside reverse transcriptase inhibitor, which causes symptoms of withdrawal in a third to half of prisoners on methadone unless methadone doses are escalated soon after ART initiation (Altice et al, 2010; Gruber and McCance-Katz, 2010).…”

Section: Discussionmentioning

confidence: 99%

Within-prison drug injection among HIV-infected male prisoners in Indonesia: A highly constrained choice

Culbert¹,

Waluyo²,

Iriyanti³

et al. 2015

Drug and Alcohol Dependence

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Background In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released. Aims This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia. Methods 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory. Results Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR=3.29, 95%CI=1.30–8.31, p=0.011) and daily drug injection before arrest (AOR=5.23, 95%CI=1.42–19.25, p=0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment. Conclusions Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.

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Section: Discussionmentioning

confidence: 99%

Within-prison drug injection among HIV-infected male prisoners in Indonesia: A highly constrained choice

Culbert¹,

Waluyo²,

Iriyanti³

et al. 2015

Drug and Alcohol Dependence

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“…In addition to diffusing information, training can help individuals to reconcile beliefs that an innovation, such as pharmacotherapy, is incompatible with the values of their profession (Marinelli-Casey, Domier, & Rawson, 2002). Criminal justice and corrections staff often have limited knowledge regarding addiction pharmacotherapy as well as negative attitudes toward this form of treatment (Lee & Rich, 2012; Rich, et al, 2005), but training has been previously shown to improve attitudes and knowledge (Gjersing, Butler, Caplehorn, Belcher, & Matthews, 2007; McMillan & Lapham, 2005). …”

Section: Methodsmentioning

confidence: 99%

“…naltrexone, acamprosate, and disulfiram (Abraham, Knudsen, Rieckmann, & Roman, 2013) and buprenorphine for the treatment of opioid dependence (Knudsen, Ducharme, & Roman, 2007; Knudsen, Ducharme, Roman, & Link, 2005); (3) an instrument to assess abstinence orientation and disapproval of drug use (Gjersing, et al, 2007); and (4) items to assess current and future intent to refer clients to pharmacotherapy (Varra & Hayes, 2007; Varra, Hayes, Roget, & Fisher, 2008). …”

Section: Methodsmentioning

confidence: 99%

Effect of an Organizational Linkage Intervention on Staff Perceptions of Medication-Assisted Treatment and Referral Intentions in Community Corrections

Friedmann

Wilson

Knudsen

et al. 2015

Journal of Substance Abuse Treatment

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Introduction Medication-assisted treatment (MAT) is effective for alcohol and opioid use disorders but it is stigmatized and underutilized in criminal justice settings. Methods This study cluster-randomized 20 community corrections sites to determine whether an experimental implementation strategy of training and an organizational linkage intervention improved staff perceptions of MAT and referral intentions more than training alone. The 3-hour training was designed to address deficits in knowledge, perceptions and referral information, and the organizational linkage intervention brought together community corrections and addiction treatment agencies in an interagency strategic planning and implementation process over 12 months. Results Although training alone was associated with increases in familiarity with pharmacotherapy and knowledge of where to refer clients, the experimental intervention produced significantly greater improvements in functional attitudes (e.g. that MAT is helpful to clients) and referral intentions. Corrections staff demonstrated greater improvements in functional perceptions and intent to refer opioid dependent clients for MAT than did treatment staff. Conclusion Knowledge, perceptions and information training plus interorganizational strategic planning intervention is an effective means to change attitudes and intent to refer clients for medication assisted treatment in community corrections settings, especially among corrections staff.

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“…There exists a poor understanding of opioid dependence as a chronic and recurring disease; some clinicians may feel that a hedonistic practice indicates a weakness of character [5,24]. Another widespread but mistaken belief involves the benefits of abstinence for drug users, which leads to the omission of maintenance therapy after detoxification, which in turn leads to reversion to opioid use [31]. In Her Majesty's Prison at Leeds, 43% of prisoners with an illicit opioid habit continued to acquire and use opioids even through the first days of imprisonment and completion of a detoxification regimen [32].…”

Section: Why Is Drug Treatment For Prisoners Not Yet Comparable To Thmentioning

confidence: 99%

Drug use and opioid substitution treatment for prisoners

Stöver

Michels

2010

Harm Reduction Journal

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Drug use is prevalent throughout prison populations, and, despite advances in drug treatment programmes for inmates, access to and the quality of these programmes remain substantially poorer than those available for non-incarcerated drug users. Because prisoners may be at greater risk for some of the harms associated with drug use, they deserve therapeutic modalities and attitudes that are at least equal to those available for drug users outside prison. This article discusses drug use by inmates and its associated harms. In addition, this article provides a survey of studies conducted in prisons of opioid substitution therapy (OST), a clinically effective and cost-effective drug treatment strategy. The findings from this overview indicate why treatment efforts for drug users in prison are often poorer than those available for drug users in the non-prison community and demonstrate how the implementation of OST programmes benefits not only prisoners but also prison staff and the community at large. Finally, the article outlines strategies that have been found effective for implementing OST in prisons and offers suggestions for applying these strategies more broadly.

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Attitudes and beliefs towards methadone maintenance treatment among Australian prison health staff

Cited by 24 publications

References 20 publications

Within-prison drug injection among HIV-infected male prisoners in Indonesia: A highly constrained choice

Within-prison drug injection among HIV-infected male prisoners in Indonesia: A highly constrained choice

Effect of an Organizational Linkage Intervention on Staff Perceptions of Medication-Assisted Treatment and Referral Intentions in Community Corrections

Drug use and opioid substitution treatment for prisoners

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