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DOCUMENT 2013 HTM file
Community loses from failure to offer maintenance prescribing in prisons
An international team of experts has argued that failure to implement effective opioid maintenance programmes in prison represents an important missed opportunity to engage high-risk drug users in treatment, at possibly substantial costs to the individuals and to the community. Is Britain too losing out, and how does the future look?
Maintenance prescribing of drugs like methadone to heroin-dependent prisoners seems to reduce injecting and the sharing of injecting equipment, changes which should reduce the risk of becoming infected with HIV.
Failure to find effects concentrated in the first two weeks after release persuaded analysts that widespread methadone prescribing in Scottish prisons from 2002 did not reduce the rate of drug-related deaths after release. But over 12 weeks the rate did fall substantially, and methadone treatment may have helped.
From the USA, a rare randomised trial found in favour of continuing methadone maintenance when patients entered prison rather than compulsory withdrawal. The potential benefits were most apparent in the near-100% continuation of protective treatment during the highly overdose-prone weeks after leaving prison.
At issue was whether by successfully referring heroin users to treatment, probation services in England would protect them from fatal overdose and prevent drug-related crime. Yes to one, but not the other, were the answers; in fact, crime went up.
STUDY 2000 PDF file 121Kb
Community solidarity and civil law important tools in reducing drug-related nuisance and crime
Lessons from Australia and the USA about the potentially harm-producing effects of police crackdowns on street drug dealing and use scenes and the benefits to the community of collective action on the part of residents and property owners.
STUDY 2003 PDF file 130Kb
What happens when heroin supplies dry up?
The 2001 'heroin drought' in Australia can be seen as a test of what might happen if enforcement authorities dramatically reduced heroin supplies in a country with a thriving heroin market patronised by an established population of heroin addicts.
REVIEW 2009 HTM file
Refocusing drug-related law enforcement to address harms
'Target enforcement to reduce individual and community harm' is the premise of this report from a UK drug policy think tank, one which seems widely understood, though in some quarters, deeply contested.
REVIEW 2009 HTM file
Alcohol and drug screening of occupational drivers for preventing injury
Exhaustive search finds just two rigorous studies of workplace testing for alcohol and/or drug use of people employed as drivers. For drugs there was some evidence of a long-term effect in averting injuries and deaths but in respect of both drugs and alcohol the evidence was too thin to support any particular policy.
STUDY 2015 HTM file
Using behavioral triage in court-supervised treatment of DUI offenders
From California, the first evaluation of a system which escalated drink/drug drivers to treatment if they failed a less intensive sentence found significantly reduced recidivism and accidents, and evidence that injuries related to accidents also fell.
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