Patient motivations, perceptions and experiences of opioid substitution therapy in prison

February 2016
Sindicich, N., Zador, D., Larney, S., & Dolan, K. (2016). Patient motivations, perceptions and experiences of opioid substitution therapy in prison. NDARC Technical Report No. 332. National Drug and Alcohol Research Centre, University of New South Wales.

People with opioid dependence are overrepresented in correctional settings and opioid substitution treatment (OST) is provided in correctional settings in many jurisdictions around the world. There has been limited examination, however, of the patient experience of opioid substitution therapy (OST) in correctional settings. 

This qualitative study conducted by NDARC aimed to examine patient motivations for, and perceptions and experiences of, OST in prisons in New South Wales (NSW), Australia. Forty-seven participants were recruited from seven correctional centres across NSW between September 2012 and October 2013. All participants had a recorded history of opioid use and/or dependence. 

This study generated unique data on patient perspectives of OST in correctional settings. Findings highlight the challenges facing opioid treatment providers in prison in addressing patient ambivalence towards OST and preferences to cease OST prior to release, and can inform the development of policies and clinical practices that are mindful of patient perspectives and concerns. These results are suggestive of the need for further work examining how best to attract and retain opioid dependent prisoners in treatment, including provider perspectives; evaluation of programs designed to increase post-release retention in OST (and other care), and quantitative analyses of retention in OST in prison and post-release.