Maintenance therapy and 3‐year outcome of opioid‐dependent prisoners: a prospective study in France (2003–06)

Abstract

Prescription of maintenance therapy has increased sharply in French prisons since its introduction in the mid-1990s. However, the risk of re-imprisonment or death remains high among opioid-dependent prisoners. Substantial efforts are needed to implement more effective preventive policies.

Impact of Methadone Maintenance Treatment on Women Offenders' Post-Release Recidivism

“…Community-based MMT participation was determined by way of urinalysis results, a potentially imperfect proxy measure, since women offenders' involvement in community-based MMT was not obtainable using other, more objective methods as offenders are not required to share relevant treatment information with CSC once released. Notably, previous studies which did not find an association between prison-based MMT participation and recidivism cite the inability to examine continuous MMT in the community as a key limitation [51,54]. Therefore, there may have been (unintended) selection bias, and results cannot be generalized to the total of CSC's MMT or other correctional populations.…”

“…Similarly, most women offenders in CSC's OMT have a history of physical (81%), mental (74%) and/or sexual (67%) abuse and have had treatment for a mental health issue [37]. In addition, non-availability of community resources (especially for offenders released to rural areas), the inability of case management to coordinate with community service providers, and the breadth of reintegration issues facing women offenders may not ensure the seamless corrections-to-community transition of treatment, especially with regard to OMT [50,51,52,53]. …”

Patients on Opioid Substitution Treatment in the Republic of Macedonia: What Do Treatment Demand Data Tell Us?

“…It has been estimated that up to one third of all heroin dependent people pass through a correctional facility each year [55]. The chronic nature of untreated heroin dependence means that imprisonment is usually a repeated experience; in studies in the US and France, half of heroin users released from prison were returnees in prison within six months [56][57].…”

[Commentary] DATABASE LINKAGE: OUTSIDE REFLECTIONS ON HEALTH CARE INSIDE PRISONS

“…Marzo et al [1] have engaged 40% of France's remand prisons (47/117) in an important 'proof-of-concept' study on the prevalence and impact of prison maintenance therapy (PMT).…”

“…As the study by Marzo et al [1] demonstrates, obtaining consent is difficult when it is an unresourced responsibility upon hard-pressed prison doctors and, even when obtained, self-report data about injecting may have been less frank [9] because the interviewer was the person (prison doctor) who also determined the prisoner's PMT. For example, a more than 20% prevalence of hepatitis C virus (HCV)-positive serology among 170 self-reported never-intravenous drug users (never-IDUs) gives immediate cause for public health concern-most especially if prisoners did not misreport their injector-status.…”