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LETTERS: Steve Simpson Maintenance programmes are denied to addicted prisoners in Victoria BMJ 1999; 318: 811 [Full text]

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Support for dependency treatments in prison.

Andrew Byrne   (23 March 1999)

Support for dependency treatments in prison. 23 March 1999
Andrew Byrne, General Practice, Drug and Alcohol Redfern, NSW, Australia Send response to journal: Re: Support for dependency treatments in prison.	Dear Editor, I agree completely with Steve Simpson that prison authorities are responsible for continuing any ethical, approved treatment for inmates in their care, including provision of methadone maintenance treatment (MMT) or naltrexone for those who are opioid dependent. By implication, in an absence of appropriate treatment, and if inmates suffer complications from drug use, then the authorities, public or private, could clearly be held responsible. Prison authorities should also initiate methadone treatment where appropriate. This is especially important pre-release since this period is associated with the highest risk of overdose (Seaman SR, Brettle RP, Gore SM. Mortality from overdose among injecting drug users recently released from prison: database linkage study. BMJ 1998;316:426-428 - 7 Feb). The authorities in many jurisdictions probably break international treaties by denying MMT to inmates. It is to be hoped that the legal process will encourage jail authorities to do the right thing, although it will be too late for some in Victoria. To my knowledge, there has been no criticism from serious observers of the widespread prison methadone treatment service in the adjacent state of New South Wales where it have been available for over 10 years in appropriately assessed patients. A careful examination of the costs and benefits of MMT in jail will ensure its eventual introduction everywhere, just like community treatment which, despite delays, is now accepted in most western countries as well as parts of the third world. Yours faithfully, Andrew Byrne .. Dr Andrew Byrne, General Practitioner, Drug and Alcohol, 75 Redfern Street, Redfern, New South Wales, 2016, Australia author of: "Methadone in the Treatment of Narcotic Addiction" and "Addict in the Family".