Intended for healthcare professionals


Maintenance programmes are denied to addicted prisoners in Victoria

BMJ 1999; 318 doi: (Published 20 March 1999) Cite this as: BMJ 1999;318:811
  1. Steve Simpson (steve.simpson{at}, Counsellor.
  1. Barkly Street Medical Centre, 60 Barkly Street, St Kilda, 3182 Victoria, Australia

    EDITOR—In my role as a peer programme advisor (infection control, harm minimisation) and as a drugs and alcohol counsellor at a Melbourne centre with over 700 patients on methadone and 300 on naltrexone I wonder at the prison system in Victoria.

    We have no maintenance program for methadone, no needle exchange, and do not allow inmates to continue on naltrexone programmes when they enter prison. But we do provide harm minimisation sessions, mandatory HIV and hepatitis sessions, and bleach for injecting equipment.

    If we are to go some way towards providing similar medical treatment to that provided in the community we should at least allow prisoners to continue on methadone and the more recent naltrexone programmes. Some of our patients who were taking naltrexone when they entered prison were denied further treatment. What happens if one of these patients lapses and we have a death from overdose? Is there not a duty of care?

    Prisoners' families were funding naltrexone treatment, which constitutes an abstinence program. Surely this practice should be emulated in prison as well as the methadone maintenance programmes described by Byrne and Dolan.1