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Open Access
Article
Publication date: 18 September 2019

Farrukh Alam, Nat Wright, Paul Roberts, Sunny Dhadley, Joanne Townley and Russell Webster

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…

2346

Abstract

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.

Details

International Journal of Prisoner Health, vol. 15 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Content available
Article
Publication date: 28 January 2021

Christina Marel, Katherine L. Mills, Robert Stirling, Jack Wilson, Paul Haber and Maree Teesson

563

Abstract

Details

Advances in Dual Diagnosis, vol. 14 no. 1
Type: Research Article
ISSN: 1757-0972

Open Access
Article
Publication date: 19 December 2022

Hyejin Park, Blake Linthwaite, Camille Dussault, Alexandros Halavrezos, Sylvie Chalifoux, Jessica Sherman, Lina Del Balso, Jane A. Buxton, Joseph Cox and Nadine Kronfli

People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among…

Abstract

Purpose

People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.

Design/methodology/approach

The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.

Findings

A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.

Originality/value

The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Details

International Journal of Prisoner Health, vol. 19 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Open Access
Book part
Publication date: 19 November 2020

Bethany Medley

This case study examines unique overdose risks and prevention strategies for women who have used heroin during pregnancy in New York City. The overdose crisis has resulted in…

Abstract

This case study examines unique overdose risks and prevention strategies for women who have used heroin during pregnancy in New York City. The overdose crisis has resulted in increased efforts to implement drug user health services; yet, pregnant and parenting women who use drugs continue to be left behind. Three women who currently use heroin and had experienced at least one pregnancy during their heroin use history were interviewed using semi-structured qualitative interviews. Their experiences documented in this case study illustrate several gender-specific considerations when responding to the overdose crisis in New York City. Overwhelmingly, barriers to healthcare and overdose prevention were correlated with perceived stigma and the fear of or actual loss of child custody. Compassionate, gender-responsive interventions remain largely absent in policy and practice, especially for pregnant women. The shared experiences highlighted in this case study should be used to develop improved drug user health policies and practices as well as increase overall advocacy efforts for women of reproductive age who use drugs.

Details

The Impact of Global Drug Policy on Women: Shifting the Needle
Type: Book
ISBN: 978-1-83982-885-0

Open Access
Article
Publication date: 24 February 2015

Gamal Sadek, Zack Cernovsky and Simon Chiu

Several studies reported high rates of psychiatric commorbidity among methadone patients. We examined the relationships of measures of psychopathology to outcomes of screening…

Abstract

Several studies reported high rates of psychiatric commorbidity among methadone patients. We examined the relationships of measures of psychopathology to outcomes of screening urine tests for cocaine, opiates, and benzodiazepines in a sample of 56 methadone patients. They also completed the Symptom Check List-90-Revised (SCL-90-R). The highest scales in the SCL-90-R profile of our patients were those indicating somatic discomfort, anger, phobic anxiety, paranoid ideation, and also obsessive-compulsive disorder symptoms (scores above the 39th per centile). The only significant correlations between urine tests and SCL-90-R psychopathology were those involving benzodiazepines: patients with urine tests positive for benzodiazepines had lower social self-confidence (r=0.48), were more obsessive-compulsive (r=0.44), reported a higher level of anger (r=0.41), of phobic tendencies (r=40), of anxiety (r=0.39), and of paranoid tendencies (r=0.38), and also reported more frequent psychotic symptoms (r=0.43).

Details

Mental Illness, vol. 7 no. 1
Type: Research Article
ISSN: 2036-7465

Keywords

Content available
Article
Publication date: 17 August 2011

Morag MacDonald, Robert Greifinger and David Kane

119

Abstract

Details

International Journal of Prisoner Health, vol. 7 no. 4
Type: Research Article
ISSN: 1744-9200

Open Access
Book part
Publication date: 19 November 2020

Abstract

Details

The Impact of Global Drug Policy on Women: Shifting the Needle
Type: Book
ISBN: 978-1-83982-885-0

Open Access
Book part
Publication date: 19 November 2020

Daria Matyushina-Ocheret

Eastern Europe and Central Asia (EECA) is home to 21% of the world’s population of people who inject drugs and it is the region with the fastest-growing HIV epidemic. HIV…

Abstract

Eastern Europe and Central Asia (EECA) is home to 21% of the world’s population of people who inject drugs and it is the region with the fastest-growing HIV epidemic. HIV prevalence among women who inject drugs is significantly higher than among men in EECA. Even in places with high coverage of needle syringe programmes and HIV testing and treatment, women’s access to opioid substitution treatment is lower than men, and women’s sexual and reproductive health needs remain unaddressed. EECA has a unique system of drug registries that store the personal data of people who use drugs. Registration lowers the chances of employment and access to education and for women and increases the risk of losing custody of their children. The system of drug registries contributes to drug-related stigma. Breaches of confidentiality of drug registry data lead to the further marginalisation of women who use drugs. Criminalisation, past experience of police violence and poverty contribute to healthcare access barriers for women. There is a need for legislative changes to improve personal data protection, decriminalise drug use and reduce police violence. The positive effects of these changes would only be seen in the long term. In the interim, women need special access programmes that are designed specifically to address their needs, that provide free-of-charge services and that ensure the safety and confidentiality of personal data.

Details

The Impact of Global Drug Policy on Women: Shifting the Needle
Type: Book
ISBN: 978-1-83982-885-0

Open Access
Book part
Publication date: 16 August 2023

Angus Bancroft

In this chapter, the author examines the way in which the purchase and delivery infrastructure of darknet cryptomarkets shapes the experience of opiate drug use and dependence. It…

Abstract

In this chapter, the author examines the way in which the purchase and delivery infrastructure of darknet cryptomarkets shapes the experience of opiate drug use and dependence. It uses the concept of social time and posits that the illicit drug distribution system reshapes two temporal dimensions shaping the experience of drug users. There is the experience of time located in the pharmacology of the drug and in the body of the drug user, which evokes experiences of withdrawal and dependence. Then there is the socio-technical embedding of the delivery system and governance structures which support or impinge on the autonomy of the user. This ‘drug time’ is both a benefit and a cost of engaging in cryptomarket use. The market infrastructure can give users the opportunities to more carefully manage their drug time, while also creating new risks of non-delivery that can sharpen experiences of dope sickness. The author concludes that the growing professionalisation, digitisation, and commercialisation of the drug market increasingly embed drug time in material infrastructures mediated through technical systems.

Details

Digital Transformations of Illicit Drug Markets: Reconfiguration and Continuity
Type: Book
ISBN: 978-1-80043-866-8

Keywords

Content available
Article
Publication date: 4 March 2020

Aysel Sultan and Aleksi Hupli

782

Abstract

Details

Drugs and Alcohol Today, vol. 20 no. 1
Type: Research Article
ISSN: 1745-9265

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