Opioid substitution therapy as a strategy to reduce deaths in prison: Retrospective cohort study

Larney, Sarah; Gisev, Natasa; Farrell, Michael; Dobbins, Timothy; Burns, Lucy; Gibson, Amy; Kimber, Jo; Degenhardt, Louisa

doi:10.1016/j.drugalcdep.2014.09.373

Cited by 6 publications

(7 citation statements)

References 11 publications

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“…Bird & Hutchinson found that males aged 15-35 years had a DRD risk seven times (95% CI = 3. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] higher in the first than per 2 weeks in the subsequent 10 weeks [2]. Further, 60% of DRDs within 12 weeks of release had occurred within the first 2 weeks.…”

Section: Introductionmentioning

confidence: 96%

“…Opiate substitution therapy (OST) aims to reduce the use of illegal and injected opiates by providing safer substitutes such as oral methadone. Provision of OST in prisons, besides being good clinical practice, seems to have contributed to a reduction of in-prison deaths [11], including suicides by younger inmates [12] and of injecting while in prison, with its attendant risks of blood-borne virus transmission [13][14][15][16][17]. Another possible benefit of prison-based OST might be to prevent the loss of opiate tolerance and so reduce the risk of DRD after release.…”

Section: Introductionmentioning

confidence: 99%

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Impact of opioid substitution therapy for Scotland's prisoners on drug‐related deaths soon after prisoner release

et al. 2015

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AimTo assess whether the introduction of a prison‐based opioid substitution therapy (OST) policy was associated with a reduction in drug‐related deaths (DRD) within 14 days after prison release.DesignLinkage of Scotland's prisoner database with death registrations to compare periods before (1996–2002) and after (2003–07) prison‐based OST was introduced.SettingAll Scottish prisons.ParticipantsPeople released from prison between 1 January 1996 and 8 October 2007 following an imprisonment of at least 14 days and at least 14 weeks after the preceding qualifying release.MeasurementsRisk of DRD in the 12 weeks following release; percentage of these DRDs which occurred during the first 14 days.FindingsBefore prison‐based OST (1996–2002), 305 DRDs occurred in the 12 weeks after 80 200 qualifying releases, 3.8 per 1000 releases [95% confidence interval (CI) = 3.4–4.2]; of these, 175 (57%) occurred in the first 14 days. After the introduction of prison‐based OST (2003–07), 154 DRDs occurred in the 12 weeks after 70 317 qualifying releases, a significantly reduced rate of 2.2 per 1000 releases (95% CI = 1.8–2.5). However, there was no change in the proportion which occurred in the first 14 days, either for all DRDs (87: 56%) or for opioid‐related DRDs.ConclusionsFollowing the introduction of a prison‐based opioid substitution therapy (OST) policy in Scotland, the rate of drug‐related deaths in the 12 weeks following release fell by two‐fifths. However, the proportion of deaths that occurred in the first 14 days did not change appreciably, suggesting that in‐prison OST does not reduce early deaths after release.

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Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Impact of opioid substitution therapy for Scotland's prisoners on drug‐related deaths soon after prisoner release

et al. 2015

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“…Further changes to grant exemptions for trained peer workers to supply naloxone, as is common practice in Scotland (through the established naloxone peer education initiative [24]), are important avenues to explore. In addition, the provision of opioid substitution treatment combined with pre-release/postrelease programs with naloxone may help to address the high level of opioid-related mortality that has been observed following release from incarceration [25].…”

Section: Futurementioning

confidence: 99%

Naloxone rescheduling in Australia: Processes, implementation and challenges with supply of naloxone as a ‘pharmacist only’ over‐the‐counter medicine

Pricolo

Nielsen

2017

Drug and Alcohol Review

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“…This treatment is potentially lifesaving not only prior to release but also during incarceration. Among incarcerated people, the hazard of all-cause in-prison death during the first four weeks of incarceration was 94 percent lower while on opioid agonist therapy than while not on it [20].…”

Section: Clinical Evidence Base For Opioid Agonist Therapymentioning

confidence: 99%

Why It's Inappropriate Not to Treat Incarcerated Patients with Opioid Agonist Therapy

Wakeman¹

2017

AMA Journal of Ethics

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Due to the criminalization of drug use and addiction, opioid use disorder is overrepresented in incarcerated populations. Decades of evidence supports opioid agonist therapy as a highly effective treatment that improves clinical outcomes and reduces illicit opioid use, overdose death, and cost. Opioid agonist therapy has been both studied within correctional facilities and initiated prerelease. It has been found to be beneficial, yet few incarcerated persons receive this evidence-based treatment. In addition to not offering treatment initiation for those who need it, most correctional facilities forcibly withdraw stable patients from opioid agonist therapy upon their entry into the criminal justice system. This approach limits their access to evidence-based health care and results in negative outcomes for individuals, communities, and society.

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Opioid substitution therapy as a strategy to reduce deaths in prison: Retrospective cohort study

Abstract: Objectives: To describe deaths in prison among opioid-dependent people, and examine associations between receipt of opioid substitution therapy (OST) and risk of death in prison.

Cited by 6 publications

References 11 publications

Impact of opioid substitution therapy for Scotland's prisoners on drug‐related deaths soon after prisoner release

Impact of opioid substitution therapy for Scotland's prisoners on drug‐related deaths soon after prisoner release

Naloxone rescheduling in Australia: Processes, implementation and challenges with supply of naloxone as a ‘pharmacist only’ over‐the‐counter medicine

Why It's Inappropriate Not to Treat Incarcerated Patients with Opioid Agonist Therapy

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