The risk of overdose and other drug-related harms among imprisoned people could be lessened under a series of new recommendations from an expert panel led by Western Health addiction medicine specialists.
Dr Thileepan Naren and Dr Jon Cook are part of a consortium – the National Prisons Addiction Medicine Network – that provides advice on the medical care of incarcerated people with substance dependence.
The network has released a study and consensus statement, published this month in the prestigious Medical Journal of Australia, that outlines 19 recommendations for the treatment of opioid addiction in custodial settings.
On any given day in Australia, more than 40,000 people are imprisoned. It is estimated that of these, two-thirds have used illicit drugs in the previous year, and more than 30% have an opioid addiction.
Opioid agonist treatment (OAT) is an effective and evidence-based treatment for opioid dependence. It reduces drug use and drug-related harms, including the likelihood of contracting infectious diseases, and the risk of overdoses.
However, the network’s study found ‘access to and uptake of OAT in prisons is suboptimal and inconsistent’ across Australia, exposing those with opioid dependence to greater risk while in prison, and after their release.
Dr Thileepan Naren, a general practitioner and addiction medicine specialist at Western Health, said it was important to treat opioid use disorder and opioid withdrawal promptly.
‘Identifying someone who needs opioid agonist therapy, and starting this promptly, can really impact the trajectory of their healthcare,’ Dr Naren.
‘Opioid agonist therapy can help with withdrawal management, maintain opioid tolerance during incarceration and decreases the risks of opioid overdose post release from prison. It can be life-saving treatment.'
The National Prisons Addiction Medicine Network makes 19 recommendations to government, health authorities and custodial health services in its consensus statement.
These recommendations include the screening of people entering prisons for opioid dependence, ongoing treatment for those already on OAT, and better support once people have been released.
Dr Jon Cook, head of Western Health’s Addiction Medicine Unit, said: ‘Western Health's Addiction Medicine team is providing leadership that is improving care for people in prisons across Australia.’
