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The study evaluated the introduction of naltrexone in an Australian prison system for imprisoned male heroin users. Treatment outcomes were analysed for two sub‐samples taken from an unsuccessful randomised controlled trial. The first sample comprised 68 participants who were randomly allocated to naltrexone treatment. The second sample comprised 47 participants who commenced opioid pharmacotherapy during the study period. Thirteen per cent of subjects started naltrexone, with only 7% retained in treatment at six months. Six‐month retention was significantly lower in naltrexone compared to methadone (p = 0.0007). Poor patient acceptability and retention did not support oral naltrexone maintenance in this treatment group.

Recent political commentary in the USA has suggested that there is great potential for current criminal justice practices designed for drug-involved offenders to be significantly overhauled in the near future. It is imperative to plan for these changes by assessing how well current programs serve drug-involved criminal justice populations. The paper aims to discuss these issues.

This critical assessment begins with an overview of the most recent research on the prevalence and impact that substance use disorders have within the criminal justice system. Although the evidence demonstrates that relying on incarceration as a crime control method for drug-involved offenders has many shortcomings, there are innovative new programs being adopted across the country. Two of these promising programs are discussed, as well as the potential results that could be realized from integrating medication assisted treatment into appropriate criminal justice programs designed for drug-involved offenders.

Incarceration is a failed practice for attending to the underlying reasons why many drug-involved offenders become involved in criminal activities. There are encouraging new programs emerging in different parts of the USA, but the inclusion of supplemental treatment options could further promote positive outcomes.

The impending expansion of criminal justice programs for drug-involved offenders must consider how innovative new programs can be fused with supplemental treatment options to achieve the best results.

The purpose of this paper is to give an overview of the scientific evidence for reduced drinking in alcohol use disorders. While the aim of alcohol use disorders (AUD) treatment usually focuses on abstinence, only a minority of individuals with AUD enter treatment. Lack of alternative treatment goals, including reduced drinking instead of abstinence, have been identified as a potential barrier for treatment entry. Epidemiological and treatment outcome studies reveal that a large proportion of individuals with AUD are able to substantially reduce their alcohol intake for a prolonged duration of time.

A narrative review of the literature on prevalence rates and health effects as well as evidence-based approaches fostering reduced drinking in individuals with AUD is presented.

Reduced drinking is associated with improvements in both morbidity and mortality. Research has identified evidence-based psychosocial and pharmacological treatment approaches; however, implementation is still scarce.

Target groups for interventions fostering drinking reduction instead of abstinence are defined and desiderata for further research are outlined.

The purpose of this paper is to understand prisoner perceptions on being trained and having received take-home naloxone (THN) kits once released from prison back into the community, in order to prevent an opiate-related overdose.

A survey was run of all prisoners receiving THN training across ten prisons in one English region. In total, 142 prisoners were surveyed out of 206 (69 per cent) being trained in THN across the ten prisons. Five focus groups (n=26) with prisoners were conducted across four remand and one open prison that included discussions on THN within a range of topics. Discussions were recorded using short-hand and the data were subsequently thematically interpreted using visual mapping techniques.

The survey highlighted a high degree of exposure amongst prisoners to overdose either directly (54 per cent) or having witnessed another person’s overdose (73 per cent). For prisoners who had overdosed, only a minority (38 per cent) were taken to hospital by an ambulance. In total, 81 per cent of prisoners surveyed also expressed little or no knowledge about THN prior to training. Prisoners were resistant to THN as an intervention resulting from this lack of prior knowledge. Focus group interviews suggested that there was a confused and mixed message in providing a harm reduction initiative within the context of recovery-orientated treatment. Prisoners also exhibited name confusion with other drugs (naltrexone) and there was some degree of resistance to being trained based on perceived side-effects brought on by its administration. Prisoners were also acutely aware of official agency perceptions (e.g. police) if seen to be in possession of THN kits.

The distribution of THN within a custodial setting requires consideration of wider marketing approaches to address levels of confusion and misapprehension amongst prisoners.

The study is one of the few focused on THN based on a UK prison environment.

Across the world, 3.3 million people die every year as a result of harmful use of alcohol. In Australia, excessive alcohol intake is responsible for 3.2 percent of the total burden of disease and injury. Disulfiram is one of the few pharmacotherapies approved for the treatment of alcohol dependence, and interferes with the metabolism of alcohol causing unpleasant symptoms as a deterrent effect. To date, no studies have examined the efficacy of disulfiram in an outpatient setting in Australia. The purpose of this paper is to describe the medium term outcomes of patients commencing disulfiram in a specialized drug and alcohol outpatient setting in Australia.

Data were extracted from outpatient clinical notes for all patients commenced on disulfiram at any location in the drug and alcohol service between January 1, and December 31, 2013.

In total, 80 patients were included in the study. At three months following commencement of treatment, 42 patients (53 percent) were considered to have been successfully retained in treatment. Totally, 36 (45 percent) patients reported remaining completely abstinent from alcohol during their first three months of treatment. Patients that self-referred to outpatient disulfiram treatment had 75 percent lesser odds of succeeding in treatment compared to those that were referred by other means (i.e. via hospital, GP or forensic services).

This study demonstrates that patients receiving supervised disulfiram for three months in the context of this treatment model can achieve abstinence. Further work is needed to compare this with other treatment options.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

In June 2001‐July 2002 the New South Wales Corrections Health Service was providing a range of health services for approximately 8,000 full‐time inmates. This figure is steadily increasing. A prison environment is a dynamic one and 17,000 inmates have come through our gates in the past year. A prison environment is efficient for transmission of infections such as HIV, Hepatitis C and Tuberculosis, to name but a few.The New South Wales Inmate Health Survey showed that about 80% of inmates have injected drugs at least once in their life, 40% report that they have injected drugs within a week prior to entry into gaol and 20% will continue to inject whilst in gaol. These figures appear repeatedly in both national and international figures. Some 80% of males and 70% of females have a history of illicit drug use.A comprehensive search of electronic databases, journal publications, conference presentations and discussions with experts involved with development of research and policy documents in regard to harm minimisation in a correctional setting was collected for this presentation. This paper attempts to look at a number of intervention strategies both nationally and internationally for prisoners to reduce their risks of acquiring a bloodborne virus. Methadone programs, bleach, condoms and prison‐based syringe exchange programmes are examined. How does Australia rate amongst other nations in reducing the risk?

In January 2013, small biotechnology firm Orexigen was in the final stages of testing Contrave, a promising new pharmaceutical product for the treatment of obesity. At the time, Orexigen had no products in the market, so all its hopes of financial success rested on this new treatment. Contrave had proven to be highly effective in clinical trials, and Orexigen executives were confident it would receive FDA approval.

At the same time, a much larger pharmaceutical company was considering acquiring Orexigen. Because the decision to acquire would ultimately be a financial one, the project team from the large company had to complete a valuation for Orexigen's only significant product in its pipeline, Contrave. What was the new product actually worth?

The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population.

Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community.

Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations.

In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.