A literature review of international implementation of opioid substitution treatment in prisons: equivalence of care?
OBJECTIVE
Opioid substitution treatment (OST) is an effective treatment for heroin dependence. The World Health Organization has recommended that OST be implemented in prisons because of its role in reducing drug injection and associated problems such as HIV transmission. The aim of this paper was to examine the extent to which OST has been implemented in prisons internationally.


METHODS
Literature review.


RESULTS
As of January 2008, OST had been implemented in prisons in at least 29 countries or territories. For 20 of those countries, the proportion of all prisoners in OST could be calculated, with results ranging from less than 1% to over 14%. At least 37 countries offer OST in community settings, but not prisons.


CONCLUSIONS
This study has identified an increase in the international implementation of OST in prisons. However, there remain large numbers of prisoners who are unable to access OST, even in countries that provide such programs. This raises issues of equivalence of care for prisoners and HIV prevention in prisons.
Larney
Sarah
S
Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, N.S.W., Australia. s.larney@unsw.edu.au
Dolan
Kate
K
D002047:Buprenorphine / Q000627:therapeutic use*; D015658:HIV Infections / Q000453:epidemiology; D006556:Heroin Dependence / Q000453:epidemiology / Q000534:rehabilitation*; D006801:Humans; D007391:International Cooperation; D008691:Methadone / Q000627:therapeutic use*; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D005791:Patient Care / Q000592:standards*; D011329:Prisoners / Q000706:statistics & numerical data; D011330:Prisons / Q000706:statistics & numerical data*
D009292:Narcotic Antagonists; D002047:Buprenorphine; D009271:Naltrexone; D008691:Methadone