6 June 1998

BMJ letter on New South Wales prison methadone treatment.

BMJ 1998;316:1744 (6 June)


Methadone treatment is widely accepted in prisons in New South Wales

EDITOR: The study by Seaman et al provides the first confirmation of what many have observed for years that there is strong evidence that appropriate treatment for drug misuse should be made available to all prisoners, especially before release.1 It is normal practice (and a requirement under international treaties) to provide medical treatment for prisoners that is similar to that which they would receive in the community. Methadone and other treatments for drug dependence should be no different. We know that there are illicit drugs in most prisons. Additionally, the prevalence of infection with HIV and hepatitis B and C is higher in prisoners than in the general population, and risk taking behaviour is widespread.

Methadone treatment was introduced into prisons in New South Wales in 1987 as a pre-release measure. Treatment has since been expanded to become more widely available for voluntary maintenance. Despite some initial misgivings, there has been almost universal acceptance of this treatment by prisoners, staff, and medical authorities. It has been associated with reduced injecting in prisons,2 and is currently being studied in relation to the transmission of blood borne viral infections.

Andrew Byrne, General practitioner.
75 Redfern St, Redfern, 2016 NSW, Australia

Kate Dolan, Senior research fellow.
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, 2033 NSW, Australia
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[Abstract/Full Text]. (7 February.)
Dolan K, Hall W, Wodak A. Methadone maintenance reduces injecting in prison. BMJ 1996; 312: 1162.