Medication-Assisted Treatment of Opioid Dependence in Prison

Prisons are not the right place for treating drug dependent men and women, and countries should develop policies for alternatives to imprisonment. As long as these alternatives have not been developed and implemented, prison authorities are faced with this specific population, in need of treatment, care and support. Research has shown that substitution therapy is the most effective way to treat opioid dependence, to reduce the risk of HIV and hepatitis C transmission, and to reduce the risk of overdose.

The course is based on the expertise of scientists and medical doctors/psychiatrists/healthcare professionals working in the field of substitution treatment in prisons. Relevant international literature and databases have been reviewed in order to develop the best evidence-based guidance. The publication follows the guidance and recommendations of several international publications such as the WHO Regional Office for Europe: Prisons and Health, 2014. A WHO guide to the essentials in prison health, the UNODC/UNAIDS/WHO framework for HIV prevention, care, treatment and support in prison settings, as well as the WHO/UNAIDS/UNODC Evidence for actions technical paper: Interventions to address HIV in prisons – Drug dependence treatment.

See "Introduction" for more information about the course.

25 activities 25m 00s of videos 01h 16 minutes of reading

I - Introduction

II - What is medication-assisted treatment (MAT) of opioid dependence? Part I

In this part you'll find out the main goals of MAT, you'll see how differ agonists from antagonists and you'll read about the benefits of MAT

III - What is medication-assisted treatment (MAT) of opioid dependence? Part II

In this part you'll find out to use methadone in substitution therapy, you'll see how differ substitution treatment regimens, you'll read  how to use buprenorphine and sustained-release morphine in substitution therapy. At the end you'll find out how to use naltrexone as a prevent to addiction.

IV - Medication-assisted treatment (MAT) of opioid dependence in prisons

In this part you'll find out how to implement MAT in a prison and you'll read about the role of psychological and social care in prison.

V - Some basic information about medication-assisted treatment (MAT)

In this part you'll find out the basic information for the patient on MAT, you'll read about how a patient can continue treatment after commencement or termination of prison sentence. At the end we describing the links between MAT and treatment of blood-borne infections (eg HIV / AIDS, HBV, HCV) and others (eg tuberculosis or sexually transmitted diseases).

VI - Medical ethics aspects of MAT programmes in prisons

In this part we presentation of the ethical basis of MAT