Abstract
BackgroundInternationally there is policy support for the introduction of methadone maintenance programmes into prison settings. Increasingly GPs are encouraged to undertake this work although concerns remain regarding the safety of such programmes. This study sought to evaluate the impact and safety of the introduction of a general practitioner with a special interest (GPsi) in substance misuse led methadone prescribing service into a UK prison between 2003 and 2010.MethodsTime series analysis of secondary prescribing data pertaining to opiate maintenance therapies, opiate detoxification therapies and opiate related deaths for the time period 2003 to 2010.ResultsResults show that following introduction of a GPsi in substance misuse there was a statistically significant increase in both methadone maintenance and detoxification treatments. Over time the rate of methadone maintenance prescribing plateaued with a corresponding decrease in the rate of methadone detoxification prescribing. There were no methadone related deaths in prison over the study period.ConclusionThe phased introduction of opiate replacement therapies into a busy remand prison did not result in any deaths within the prison for which opiate replacement was identified as the cause. GPsi led opiate prescribing programmes can be introduced safely into secure environments.
Highlights
There is policy support for the introduction of methadone maintenance programmes into prison settings
The introduction of a methadone maintenance programme was undertaken by a general practitioner with special interest (GPsi) in substance misuse who commenced prison based drug treatment in December 2003 in Her Majesty’s Prison (HMP) Leeds, a remand prison with a capacity for 1283 prisoners, where the average length of stay for each prisoner was thirteen weeks
Over the study period a total of 4551 patients were inducted onto methadone maintenance and 3181 patients received a detoxification treatment
Summary
There is policy support for the introduction of methadone maintenance programmes into prison settings. Published statistics show that the prison population for England and Wales was 84,586 at the end of August 2010 [1]. This figure represents an increase in the prison population of approximately 30 per cent since 1999. The increase was due to a combination of tougher sentencing and enforcement outcomes, and a more serious mix of offence groups coming before the courts. It equates to a prison population rate of 153/100,000 of the national population.
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