Alcohol and other drug programs are provided at all prisons. Programs include individual counselling, psycho-educational programs, long-term group therapy and transitional assistance programs. Access is based on an assessment of need and suitability. Every prisoner entering prison receives harm reduction education to minimise the harm associated with drug use. Show All drug treatment programs in Victoria’s prisons are based on a substantial body of research. Offenders who engage in structured cognitive behavioural treatment (CBT) interventions show reductions in drug use and reoffending. The Corrections Alcohol and Drug Strategy 2015 – Overview describes the approach to dealing with alcohol and drug use across all correctional environments in Victoria, integrating the key principles and strategies employed within both adult prison settings and community correctional services. Prisoners can access drug withdrawal support and opioid substitution therapy (such as methadone) in prison. The Opioid Substitution Therapy Program (OSTP) 2015 aims to reduce the harm associated with illicit opioid use by reducing the demand for drugs, stabilising prisoners in treatment and reducing the risk of transmission of blood-borne viruses. People entering custody who were receiving opioid substitution therapy (OST) in the community can continue their treatment in prison. Prisoners who meet the clinical criteria may also commence OST while in prison. Taking or supplying illicit drugs and drinking or supplying alcohol is illegal in Victorian prisons. Post-release pharmacotherapy dispensing subsidy programPrisonersPrisoners who receive opioid substitution therapy during their time in prison may be referred by the prison health service provider to a community pharmacy to maintain their opioid substitution treatment on release. Prisoners who are unexpectedly released from prison and do not have a referral for the program can contact the health service provider at their last prison location to organise a referral. PharmaciesThe program is fee-for-service with no advance payments available. Justice Health pays participating pharmacies a subsidy of $5 (excluding GST) per dose for up to 30 doses delivered over 4 weeks. The prisoner has up to two weeks from the date of their release to commence treatment through a pharmacy. To claim payment, participating pharmacies must: Pharmacies cannot claim GST if they are not registered for GST claims.
Worldwide, around 30 million people enter and leave prison each year. Of these people, around 4.5 million have hepatitis C, almost 1 million have HIV and 1.5 million have hepatitis B infections. In many countries, prisons are underfunded and overcrowded, and injecting drug use is common. Those who enter prison uninfected are at risk of becoming infected, as few countries provide the range of prevention programs required to halt transmission inside. Once detained, prisoners are often denied access to life-saving treatment for these infections. This lack of access to treatment and prevention programs is a human rights violation that must be addressed. A series of articles in the Lancet medical journal – released ahead of next week’s AIDS 2016 conference in Durban, South Africa – outlines how. Join 175,000 people who subscribe to free evidence-based news.Incarceration of drug usersIn the West, more than one-third of inmates have a history of drug injection. In New South Wales, it’s about half of inmates. This is in stark contrast with levels of drug injecting in the general population, which are less than 0.5% in Europe and Australia. While those in the community may not feel at risk, most inmates are released back to their communities. Many prisoners serve short sentences of about six months or less. And sentences served by women tend to be shorter, three months or so. As part of the Lancet package, we published a review of prevention programs for prisoners including education, voluntary testing and counselling, needle and syringe programs, methadone, condom provision and antiretroviral therapy for HIV. Only seven countries – Moldova, Kyrgyzstan, Germany, Luxembourg, Portugal, Spain and Switzerland – provide all six interventions in their prisons. However, the actual level of coverage in these countries remains unknown. Prevention and treatmentThe first step in addressing HIV and related infectious diseases among those incarcerated is to reduce the numbers of people in prison and detention for substance use, sex work and other non-violent offences. This change can only happen if there is agreement on what prisons can realistically do and what alternatives to prison can do better. When a sizeable proportion of inmates have a history of heroin injecting, they should be provided with methadone. Inmates on methadone are less likely to die from an overdose inside or outside prison, and less likely to pick up infections such as hepatitis C. They are also much less likely to return to prison. Yet we found just 43 countries provide methadone to inmates. Less than 1% of those who need it get it. Treatment for HIV is now so advanced the condition is a manageable one rather than a death sentence. Importantly, treatment renders HIV-positive people unable to transmit the infection to others. However, access to treatment is uneven around the world and especially in prisons. We found HIV among prisoners in virtually every country we studied, yet only 43 countries provided treatment for HIV. Prisoners should also have access to drugs to prevent HIV transmission (called pre-exposure prophylaxis or PrEP), hepatitis B vaccinations, treatments for hepatitis C infection, and condoms. Perhaps the the most important intervention is drug treatment or mental health treatment, preferably as an alternative to custodial sentences. More than 60% of prisoners have either a substance abuse problem, a mental illness or a dual diagnosis. These are illnesses that need treatment, not punishment. What about Australia?Australia compares very favourably to the rest of the world, but large gaps remain. We have prison methadone programs in most states. However, Queensland restricts this treatment to pregnant prisoners and other states are not meeting demand for the program. We still do not have a needle and syringe program in any Australian prison, even though infections are spreading. Years of research has shown these programs are safe to operate and reduce injecting and infectious diseases. The main drug injected in Australian prisons today is ice. While we are still grappling with how we can best treat these people, users should be provided with cognitive behavioural therapy (CBT) to manage their addiction and the underlying problems that led them to use. While Australia has led the way in the control of HIV in prison, it still has to control hepatitis B and hepatitis C. For every 100 people in prison who has ever injected drugs, 14 will become infected with hepatitis C each year. Treatment is available and has been provided in NSW for several years now, but most other states have not yet introduced this costly but effective treatment. If other states follow suit, we could virtually eliminate hepatitis C infection from the prison population. We need to rethink our approach to drug treatment and management in prisons to control the spread of infectious diseases – in Australia and abroad. Drug dependence is a health problem and should be treated as such. If so, you’ll be interested in our free daily newsletter. It’s filled with the insights of academic experts, written so that everyone can understand what’s going on in the world. With the latest scientific discoveries, thoughtful analysis on political issues and research-based life tips, each email is filled with articles that will inform you and often intrigue you.
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| | 17 sources Prisons are rife with people convicted of drug crimes. These individuals may have been incarcerated for a range of drug-related offenses, from driving under the influence of alcohol to possession of drug paraphernalia. Some inmates imprisoned for drug crimes do not have a drug problem. But addiction is still common among prisoners. According to The Center for Prisoner Health and Human Rights, about half of people in prison or jail meet the criteria for substance abuse or dependence. Many people with addiction also have a mental health disorder, such as depression or post-traumatic stress disorder. About 45 percent of inmates in local jails and state prisons simultaneously grapple with a substance use and psychological disorder, according to the National Institutes of Health. 45% of inmates in local jails and state prisons simultaneously grapple with a substance use and psychological disorder.  Source: National Institutes of Health However, many prisons do not provide inmates who battle addiction with proper evidence-based treatment that could save their lives. Medication-assisted treatment, which can help control withdrawal symptoms during detox, is uncommon in U.S. prisons. Research shows that in-prison treatment can save lives. Inmates who receive treatment during incarceration have a reduced risk for further substance use, experiencing relapse and drug-related death. How Prisons Serve Inmates with AddictionMany prisons support people battling addiction. A number of correctional facilities today offer psychotherapy sessions, religious ministry meetings and 12-step programs such as Alcoholics Anonymous to inmates with substance use problems. Alcoholics Anonymous meetings are common in correctional settings. These meetings aim to help inmates live a sober life in prison and after their release. This program allows prisoners to learn more about the underlying cause of their drinking problems and strategies to avoid alcohol abuse. In addition to 12-step meetings, federal prisons offer a number of programs designed to assist inmates in overcoming a substance use disorder. Well-designed prison treatment programs reduce relapse, criminality, inmate misconduct and recidivism — the likelihood that a convicted criminal will reoffend. They also increase levels of education, mend relationships, boost employment opportunities upon release and improve overall health. Research shows that residential prison treatment is cost-effective if prisoners continue treatment after their release. The cost of treatment pales in comparison to the cost of incarceration. Rehab helps prisoners overcome drug use and reduces the economic burden of recidivism. According to the report by the National Center on Addiction and Substance Abuse, if all prisoners with substance abuse problems received addiction treatment during incarceration and aftercare upon their release, the United States would break even on costs if just over 10 percent were employed and avoided drugs and crime. But not all addicted inmates receive treatment. The CASA report found that just 11 percent of inmates with substance abuse problems, including addiction, received treatment at federal and state prisons or local jails. In a 2014 editorial in The Washington Post, renowned addiction specialist David Sack suggested that prisons create an evaluation system to identify substance use disorders and underlying problems that contribute to addiction, such as trauma or anxiety. Sack also said prisons should employ trained addiction specialists who know how to use evidence-based treatment. Additionally, he recommended that more correctional facilities consider programs that support inmates after their release to help them avoid relapse. Prisons do not offer treatment plans as comprehensive as those found at traditional rehab centers. Rehab facilities include evidence-based approaches that cater to the client’s specific needs, which may include co-occurring disorders. Treatment often comprises a structured detoxification phase, psychotherapy and support group meetings. Prisons have used evidence-based methods of treatment, such as cognitive behavior therapy and self-help group meetings, but many lack detox programs.
Detox can be painful for someone with addiction. During this process, individuals experience withdrawal symptoms that may include insomnia, diarrhea, cramping and hallucinations. Some prisons employ medication-assisted therapy to help inmates deal with these symptoms. However, a 2017 report by The New York Times found that fewer than 30 jails and prisons in the United States have treatment programs that offer methadone or buprenorphine, two medications that effectively treat opioid addiction. As of March 2017, just four state prisons use these medications. Methadone weans people off their drug of choice by reducing drug cravings without producing euphoria. Methadone treatment programs have proved effective in reducing arrests and increasing employment among former inmates. Benefits of Medication-Assisted Treatment in PrisonRhode Island Department of Corrections offers a medication-assisted treatment program. Inmates battling opioid addiction have access to a range of medications that treat their addiction, including Suboxone, a combination of buprenorphine and naloxone. A 2012 study published in the journal Substance Abuse found that providing inmates with methadone treatment in the weeks before their release had significant benefits. These individuals were more likely than prisoners referred to treatment at the time of release to enter rehab upon release. Another study, published in the journal Addiction, also showed advantages to offering methadone in prison. Researchers found that prisoners who received counseling and methadone treatment were more likely to be retained in rehab than were inmates who received counseling and a transfer to methadone treatment upon release. Those who received methadone while incarcerated were also less likely than the other group to fail a drug test. Aftercare Can Reduce Relapse and RecidivismRecovering from addiction can be difficult. Upon their release, prisoners with substance abuse issues often return to environments that trigger drug cravings. This can lead to continued drug use and overdose.
Research shows that more than half of inmates with a history of addiction relapse within a month of their release. Former prisoners who have been out of jail for two weeks or less are also 129 times more likely than the general population to experience a fatal drug overdose. Completing drug rehab is a proven method for overcoming substance use disorders and reducing recidivism. In-prison treatment combined with aftercare services can also reduce recidivism rates. But those who do not receive treatment in prison can still attend rehab with aftercare programs upon their release. Aftercare provides continued care that may include outpatient care and 12-step programs. These allow ex-prisoners in recovery to communicate with and learn from people in similar situations. Support is important for ex-prisoners in recovery. Individuals who seek aftercare resources, such as 12-step meetings or individual therapy, upon their release have a greater chance of living healthy, drug-free lives. Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
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What is one commonly used method for treating drug-dependent inmates in today’s prisons?
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