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This US randomised trial in Rhode Island among formerly opiate dependent prisoners found that starting methadone treatment in prison radically improved treatment uptake on release and reduced heroin and cocaine use over the following six months, confirming results from Baltimore.
Starting methadone treatment in prison radically improves treatment uptake on release and reduces heroin and cocaine use over the following year, reports the first US randomised trial among formerly opiate dependent prisoners.
Largely due to the treatment's health benefits, this review argues 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 both to individuals and to the community.
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.
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