Opiate Substitution Therapy in Prison

Opiate substantial therapy in prisons is one of the medical technics used in the USA for curing addicted prisoners who suffer from diseases like HIV, tuberculosis, and others. There are controversial opinions related to the cost-effectiveness of this treatment. Some experts believe that this treatment approach is one of the most efficient methods to cure opiate addiction. However, others consider that this kind of treatment is rather expensive and inefficient. Strang and Tobe claimed that the Swiss authorities spent roughly $250 per OST (opioid substitute treatment) patient every day. Moreover, some proponents of OST consider its use as tantamount to the camouflaged legalization of drugs. Nevertheless, opiate substantial therapy in prisons has gained a reputable attention, and it is used in the USA prisons as well as in other countries in the world. This issue should be taken into consideration by the authorities who develop different health care programs for drug addicted prisoners.

OST as a Source of Treatment

High morbidity and mortality levels, as well as rife and rampant criminal situation coupled with its concurrent side effects that can be observed throughout the world, are a result of drug abuse. The dangerous HIV/AIDS epidemics are observed in prisons all over the world, and concurrent number of drug addicted prisoners is rising very quickly (Caplinskiene, Caplinskas, & Griskevicius, 2003). Today, treatment professionals consider OST as one of the multiple pathways of recovery from HIV/AIDs and tuberculosis. The research asserts that the high level of injection drug use together with the frequent rotation of prison populations create an ideal breeding ground for the rapid and untrammeled spread of contagious diseases, as well as other untoward drug use-related implications. Furthermore, a variety of unique possibilities to cure drug addiction and prevent the proliferation of communicable diseases among problem citizens is salient in correction facilities.

OST is a palliative drug therapy designed to terminate a persons addiction to opiates, such as heroin, by means of substituting the opiate used for methadone, buprenorphine or some other drugs. It has become a common fact that jails all around the world are teeming with homemade drugs producers that make substance form poppy seeds. Therefore, there has been an acute interest in the efficacy of OST in treating dependence of such opiates. A variety of experts argues that the therapy has little chances of reaching fruition (Strang & Tober, 2003). On the contrary, many studies have shown that OST is a course of treatment that leads to profound recovery results. Admittedly, the number of countries that espouse this therapy has been on the rise lately. Opiate therapies that rely heavily on the use of methadone or buprenorphine are the most quintessential examples of this practice.

OST Programs

OST programs are broadly used in the penal systems in the United States, EU members, Australia, Canada, Russia, Iran, Indonesia, and other countries. This tendency comports with recommendations on the part of a bunch of reputable organizations to introduce or expand OST programs in the correction facilities. OST programs aim to reduce injection behavior among inmates who take injection drugs and, thus, conduce to the reduction of mass infection in prisons. OST programs should be administered to all those who received it prior to ending up in a prison. This aspect is especially important due to the recent evidence that people who ceased to receive OST after they had been detained reverted to their old habits in the correction facilities. The research asserts that MST is more cost-effective than other methods of combating drug, e.g. every dollar invested in MST allows the authorities to save up to five dollars in the long run (Lowinson, 2005). The problem of OST is that it is not very popular with some politicians. In some countries, this program is not fulfilled even though it has been supported by both scientific and medical evidence (Okie, 2007).

There is continuing evidence that OST programs lessen the risk of the released felons engaging in illegal activities. Some researchers believe that HIV epidemic among people using injection drugs is a direct result of the caffeinated legislative efforts to tackle this ticklish problem. First of all, it is considered that OST should be administered to all those who received it prior to ending up in a prison. Secondly, the risky injection behaviors have been persisting despite decades of intervention. However, few researchers have the temerity to refute the fact that OST reduces injection behavior among inmates who take injection drugs and, thus, conduce to the reduction of mass infection in prisons. Thirdly, OST contributes significantly to the involvement of prisoners in drug addiction outreach programs by virtue of enabling them to abstain from drugs both in prison and at large. Fourthly, OST minimizes the risk of overdose occurring in injection drug users after their deliverance from prison. Lastly, OST diminishes the probability of the repeated commitment of the offense.

The Instruments of Treatment

Though, OST program is rather popular, a few number of experts consider that it cannot be used because OST is based on methadone or buprenorphine use. Though, this is the most efficacious instrument of treating opiate dependence, some countries continue frowning upon their use. The incandescent proponents of conducting opiate substitution therapies in penitentiaries adduce a string of indubitable arguments. According to the generally accepted definition, methadone is a repository synthetic opiate agonist that can be easily absorbed by the organism. Its half-value period ranges from 24 to 36 hours, which means it can be taken once a day. Methadone can successfully obstruct effects of the abstinent syndrome and euphoria induced by short-lasting opiates. As a result, methadone substitution therapy (MST) reduces major risks and side effects associated with untreated dependence on opiates among patients, who have been persuaded to undergo MST.

Lowinson (2005) suggests that the utilization of MST leads to a decrease or refusal from using opiates and fall in the levels of crime, unemployment and mortality. Moreover, a clutch of scientists indicates a decreased level of HIV and acute viral hepatitis transmissibility. The majority of researchers note that buprenorphine is a comparatively new analgesic drug used for the opiate addiction. Just like its well-known counterpart methadone, buprenorphine is a synthetic opiate agonist, which can be easily absorbed by in the human organism if taken orally. In contradistinction to methadone, buprenorphine causes a less pronounced sedative effect, decreases the appetence for other opiates, and prevents the abstinent syndrome from occurring. Thus, there is little wonder that the ever-growing catalogue of researchers tend to imply that buprenorphine substitution therapy (BST) is not fraught with risks and dangers to the same extent as methadone substitution therapy; thus, it is more conducive to the safety and availability of this therapy.

The Results of OST Programs

Many experts argue if the implementation of OST programs in prisons leads to profound results. According to the data of a randomized controlled study, the instances of inmates sharing a syringe are a rarity if they participate in OST programs. The incidence of drug use among those who undergo OST is lower as compared to those who do not engage in this treatment. It has been established that OST has a positive impact on the institutional behavior of the inmates, which makes them more pliant and docile, as well as lowers their zest for substance, diminishes their irritability and bellicosity, and, thus, ultimately strengthens security in prisons. Those inmates who receive OST are prone to seeking drug abuse treatment after their discharge from prison. Many studies indicate that methadone can successfully obstruct effects of the abstinent syndrome and euphoria induced by short-lasting opiates. As a result, methadone substitution therapy reduces major types of risks and side effects associated with untreated dependence on opiates among patients who have been persuaded to undergo MST.

This therapy has gained recognition among doctors and experts in the World Health Organization, as well as other international organizations, which reckon it to be one of the most efficient methods to cure opiate addiction. It is estimated that, in 2009, more than a million persons from 106 countries worldwide have undergone OST, and have received positive results (Wagner et al., 2010). The rise of dangerous epidemics in prison should make authorities take pre-empted measures to stop them.

As any other phenomenon, opiate substitution therapy has both merits and shortcomings. Opiate substantial therapy in prisons is one of the medical technics used in the USA for curing addicted prisoners who suffer from diseases like HIV, tuberculosis, and others. OST programs aim to reduce injection behavior among inmates who take injection drugs and, thus, conduce to the reduction of mass infection in prisons. There are different controversial opinions related to the cost-effectiveness of this treatment. Some experts believe that this treatment approach is one of the most efficient methods to cure opiate addiction. However, others consider this treatment as rather expensive and inefficient. Nevertheless, opiate substantial therapy in prisons has gained a reputable attention, and it is used in the USA prisons as well as in other countries worldwide.

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