Abstract
BackgroundOpioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Especially, under the condition of imprisonment, OMT is a preventive measure regarding infectious diseases such as hepatitis C. However, only a minority of prisoners with OUD are currently in OMT in numerous countries. In 2009, the Ministry of Justice of the federal state of North Rhine-Westphalia (NRW), Germany, launched the process of implementing OMT in prisons with various elements (e.g. development of recommendations regarding the treatment of prisoners with OUD, monitoring the number of prisoners in OMT, education of prison doctors). In the recommendations OMT was defined as the gold standard of treatment of OUD.MethodsTo assess the effectiveness of the implementation strategy a survey on the prevalence of OMT in prisons in NRW was carried out twice a year by the Ministry of Justice between 2008 and 2016. Participants were prisoners in NRW, Germany. The diagnosis of OUD at admission to prison and the treatment state on survey dates was measured.ResultsThe number of prisoners in NRW dropped from 17,301 in 2008 to 16,432 in 2016. In the same period, the number of prisoners with OUD (mainly males) dropped from 4201 persons to 3650 persons and the number of prisoners in OMT increased from 139 persons (3.3%) to 1415 (38.7%) persons.DiscussionCurrently, the percentage of prisoners with OUD in OMT in NRW is almost reaching the treatment rate outside prisons in Germany (45–50%). However, after release from prison there is still a high risk for a discontinuation of OMT.ConclusionsOverall, the top-down approach of implementing OMT in prisons in the federal state of NRW was effective.
Highlights
Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD)
In the period from 2008 to 2016, the number of prisoners in OMT increased from 139 persons out of 4201 prisoners with OUD (OMT rate: 3.3%) to 1415 out of 3650 prisoners with OUD (OMT rate: 38.8%)
A chi-square test of independence was performed to examine if OMT increased over time after the recommendations came into effect
Summary
Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Only a minority of prisoners with OUD are currently in OMT in numerous countries. In the recommendations OMT was defined as the gold standard of treatment of OUD. Opioid use disorder (OUD) in particular is associated with a high mortality rate and a high burden of disease [3]. The number of people with OUD in Germany has been estimated about 146,580–174,064 persons [4]. After several years of decrease, the number of drug-related deaths (DRD) in Germany has increased again since 2012 to 1272 DRDs in 2017 [5]. OMT has become the gold standard of treatment of patients with OUD in many countries. The rate of people affected by OUD in maintenance treatment is about 45–50% in Germany
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
