In Australia, more than 40,000 people are imprisoned every day.
More than half of these people experience drug addiction, including addiction to heroin or opioids.
For people released from prison, there is an increased risk of preventable death from drug overdose.
Burnet researchers, in partnership with Western Health, led a consortium that has developed recommendations for the use of opioid agonist treatment in custodial settings.
The study, entitled National consensus statement on opioid agonist treatment in custodial settings, was published in the Medical Journal of Australia today.
Opioid agonist treatment is used to treat heroin addiction. It reduces drug use and drug-related harms, including the likelihood of contracting infectious diseases, and the risk of overdose.
The study makes 19 recommendations to government, relevant health authorities and custodial health services about how and when opioid agonist treatment should be offered in prison settings and how
people can remain on the treatment after they are released from prison.
Opioid agonist treatment helps people manage their cravings. It also reduces the risk of drug overdose because it allows the body to maintain opioid tolerance.
One of the study's lead authors, Dr Jocelyn Chan, said the treatment reduced harms for people who inject drugs who were incarcerated.
"People who have regularly been using opioid drugs can go into withdrawal when they are incarcerated, which can be painful and dangerous," she said.
"Early identification of people who use drugs at the time of incarceration is important so they can start receiving this treatment as soon as possible."
Opioid withdrawal contributed to the 2020 death in custody of Aboriginal woman Veronica Nelson.
Key recommendations from the study include prompt recognition and treatment of opioid withdrawal and connection to community-based treatment providers on release.
The recommendations, formulated based on a rigorous evidence review, were agreed to by the National Prison Addiction Medicine Network, a panel of experts in healthcare and prison settings, including some with lived experience, across various states in Australia.
Dr Chan said the treatment allowed people to gradually reduce their dependence on opioid drugs.
"Opioid agonist treatment helps sustain the body's tolerance to the drugs so that if people use drugs again once they're released from prison, they are less likely to overdose, which is a leading cause of death among people released from prison," she said.
"When proper support networks have been established once the person has been released from prison, they will gradually be able to come off the treatment."
Dr Chan said the guidelines would improve treatment for people who inject drugs who were incarcerated.
"Implementing these recommendations will enhance the quality, consistency, and continuity of opioid agonist treatment for people who are incarcerated, both while they are in prison and once they are released," she said.
"We know anecdotally that this treatment is difficult to access, but more research is needed to find out exactly how many people are receiving the treatment in prison settings and how many more need it."
