title: Effect of prison-based opioid substitution treatment and post-release retention in treatment on risk of re-incarceration.
abstract: OBJECTIVE
  People who use heroin are frequently incarcerated multiple times. Reducing re-incarceration of this group is important for reducing both health risks associated with incarceration and the costs of correctional administration. Opioid substitution treatment (OST) in prisons may help to reduce re-incarceration, but research findings on this topic have been mixed. In this study, we examined the effect of OST in prison and after release on re-incarceration.
  
  
  METHODS
  Longitudinal cohort study. SETTING, PARTICIPANTS AND MEASUREMENTS: Data on OST and incarceration were linked for a cohort of 375 male heroin users recruited originally in prisons in New South Wales, Australia. Data were linked for the period 1 June 1997-31 December 2006. Re-incarceration was examined using recurrent-event survival analysis models. Model 1 examined the effect of OST status at release from prison (i.e. in treatment versus out of treatment on the day of release) on re-incarceration. Model 2 considered the effect of remaining in OST after release on risk of re-incarceration.
  
  
  RESULTS
  Ninety per cent of participants were re-incarcerated following their first observed release. Pre-incarceration cocaine use was associated with a 13% increase in the average risk of re-incarceration. There was no significant association between simply being in OST at the time of release and risk of re-incarceration; however, in the model taking into account post-release retention in treatment, the average risk of re-incarceration was reduced by 20% while participants were in treatment.
  
  
  CONCLUSIONS
  In New South Wales, Australia, opioid substitution treatment after release from prison has reduced the average risk of re-incarceration by one-fifth.
authors.affiliation: Centre for Health Research in Criminal Justice, Matraville, NSW, Australia. sarah.larney@justicehealth.nsw.gov.au
authors.forename: Sarah
authors.initials: S
authors.lastname: Larney
authors.forename: Barbara
authors.initials: B
authors.lastname: Toson
authors.forename: Lucy
authors.initials: L
authors.lastname: Burns
authors.forename: Kate
authors.initials: K
authors.lastname: Dolan
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009517:New South Wales; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011329:Prisoners; D012008:Recurrence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D009294:Narcotics; D008691:Methadone