Opioid substitution therapy

Opioid drugs such as heroin, morphine, oxycodone and fentanyl, are linked to various health and social problems.

Treatment with opioid substitution therapy (OST) – such as methadone, buprenorphine and suboxone – can reduce cravings, lessen withdrawal symptoms, improve physical and mental health, and reduce drug-related crime and demand for illicit drugs (Scott et al. 2015).

On a snapshot day in 2022, 55,700 people were receiving pharmacotherapy treatment for their opioid dependence across Australia. Of these people, 5,100 (9.1%) received this treatment in a correctional facility (AIHW 2023).

Periods of transition into prison provide an important opportunity to engage people in OST who may not otherwise receive and engage in treatment (Gisev et al. 2014).

People entering prison may need detoxification (for withdrawal) and longer term treatment due to sudden withdrawal from drugs. Availability of OST in prison has been linked to a reduction in drug injection and thus lower associated harms such as needle sharing and infections (Kinner et al. 2013; Lafferty et al. 2018; Schwitters 2014).

Opioid substitution therapy for prison entrants

Prison entrants were asked whether they were currently, or had ever been, on OST.

About 1 in 13 prison entrants (7.5%) reported they were currently on OST (Indicator 3.3.2).

About 1 in 6 (16%) prison entrants reported they had been on OST at some stage in their lives.

Opioid substitution therapy for people in custody

About 1.8% of people in custody were dispensed OST medication (Indicator 3.3.3).

Medications for opioid dependence were reportedly dispensed to nearly 1.8% of people in custody. But this was likely an underestimate of the true value, as not all medications typically dispensed were captured in the NPHDC.

Opioid substitution therapy for prison dischargees

About 1 in 8 (13%) prison dischargees on OST while in prison plan to continue after release (Indicator 3.3.4).

One in 13 (7.5%) prison dischargees reported currently being on OST.