People who use heroin commonly spend time in prison. Contact with treatment services after release from prison is important for reducing the risk that released heroin users will return to regular drug use. However, we know that few heroin users enter or are retained in treatment after release from prison. This project aims to examine how opioid pharmacotherapy in prison affects the probability that someone will enter, and stay in, treatment after they are released from prison.
Inadequate research attention has been given to the issue of continuity of opioid substitution therapy (OST) as an individual moves between prison and the community. Heroin users are typically released from prison multiple times over a heroin use career, and the post-release period is a time of significant morbidity and mortality. Dr Larney’s PhD research demonstrated that positive impacts of prison OST are seen only as long as an individual remains in treatment in the community. However, post-release treatment entry and retention is usually poor. Increasing rates of post-release treatment entry and retention would likely reduce the risk of relapse to regular heroin use and associated morbidity and mortality.
To determine how best to deliver opioid substitution treatment in prisons so as to maximise post-release treatment entry and retention.
Data was sourced from existing research projects being undertaken by Professor Josiah Rich of Brown University, and administrative datasets. Groups receiving OST under different service delivery models were compared on post-release treatment entry and retention; heroin and other drug use; reincarceration; and mortality.
Data collection has been completed and a manuscript of the main outcomes is being prepared.
Rich JD; McKenzie M; Larney S; Wong JB; Tran L; Clarke J; Noska A; Reddy M; Zaller N, 2015, 'Methadone continuation versus forced withdrawal on incarceration in a combined US prison and jail: a randomised, open-label trial.', Lancet, http://dx.doi.org/10.1016/s0140-6736(14)62338-2
Improvements to clinical practice as a result of this project have the potential to reduce post-release relapse to heroin use, and therefore heroin-related morbidity and mortality.