TY - JOUR
KW - Age Factors
KW - Buprenorphine/administration & dosage/therapeutic use
KW - Comorbidity
KW - Continuity of Patient Care/organization & administration
KW - Delayed-Action Preparations
KW - Drug Administration Schedule
KW - England
KW - HIV Infections/epidemiology/etiology
KW - Hepatitis C/epidemiology/etiology
KW - Humans
KW - Mental Disorders/epidemiology
KW - Methadone/administration & dosage/therapeutic use
KW - Naltrexone/administration & dosage
KW - Narcotics/administration & dosage
KW - Needle Sharing/adverse effects
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/drug therapy/prevention & control
KW - Prisons/organization & administration
KW - Quality Improvement/organization & administration
KW - Social Work/organization & administration
KW - Wales
KW - Drug Abuse
KW - drug dependence
KW - Health in prison
KW - Opioid substitution therapy
KW - Prison
KW - Prison medicine
AU - F. Alam
AU - N. Wright
AU - P. Roberts
AU - S. Dhadley
AU - J. Townley
AU - R. Webster
A1 - 
AB - PURPOSE: The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales. DESIGN/METHODOLOGY/APPROACH: A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017). FINDINGS: Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison. ORIGINALITY/VALUE: Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.
AD - Central and North West London NHS Foundation Trust, London, UK.; Transform Research Alliance, Leeds, UK.; HM Inspectorate of Prisons, London, UK.; Wolverhampton Volunteer Sector Council, Wolverhampton, UK.; Pathways to Recovery, Warrington, UK.; London, UK.
BT - International journal of prisoner health
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 4
DO - 10.1108/IJPH-12-2017-0061
IS - 4
JF - International journal of prisoner health
LA - eng
M1 - Journal Article
N2 - PURPOSE: The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales. DESIGN/METHODOLOGY/APPROACH: A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017). FINDINGS: Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison. ORIGINALITY/VALUE: Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.
PY - 2019
SN - 1744-9219; 1744-9200; 1744-9200
SP - 293
EP - 307
EP - 
T1 - Optimising opioid substitution therapy in the prison environment
T2 - International journal of prisoner health
TI - Optimising opioid substitution therapy in the prison environment
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 31532339
U3 - 10.1108/IJPH-12-2017-0061
VL - 15
VO - 1744-9219; 1744-9200; 1744-9200
Y1 - 2019
Y2 - Dec 5
ER -