Implementation of opioid maintenance treatment in prisons in North Rhine-Westphalia, Germany - a top down approach.
Germany
OMT
Opioid maintenance treatment
Prison
Journal
Substance abuse treatment, prevention, and policy
ISSN: 1747-597X
Titre abrégé: Subst Abuse Treat Prev Policy
Pays: England
ID NLM: 101258060
Informations de publication
Date de publication:
10 03 2020
10 03 2020
Historique:
received:
18
11
2019
accepted:
25
02
2020
entrez:
12
3
2020
pubmed:
12
3
2020
medline:
27
2
2021
Statut:
epublish
Résumé
Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Especially, under the condition of imprisonment, OMT is a preventive measure regarding infectious diseases such as hepatitis C. However, only a minority of prisoners with OUD are currently in OMT in numerous countries. In 2009, the Ministry of Justice of the federal state of North Rhine-Westphalia (NRW), Germany, launched the process of implementing OMT in prisons with various elements (e.g. development of recommendations regarding the treatment of prisoners with OUD, monitoring the number of prisoners in OMT, education of prison doctors). In the recommendations OMT was defined as the gold standard of treatment of OUD. To assess the effectiveness of the implementation strategy a survey on the prevalence of OMT in prisons in NRW was carried out twice a year by the Ministry of Justice between 2008 and 2016. Participants were prisoners in NRW, Germany. The diagnosis of OUD at admission to prison and the treatment state on survey dates was measured. The number of prisoners in NRW dropped from 17,301 in 2008 to 16,432 in 2016. In the same period, the number of prisoners with OUD (mainly males) dropped from 4201 persons to 3650 persons and the number of prisoners in OMT increased from 139 persons (3.3%) to 1415 (38.7%) persons. Currently, the percentage of prisoners with OUD in OMT in NRW is almost reaching the treatment rate outside prisons in Germany (45-50%). However, after release from prison there is still a high risk for a discontinuation of OMT. Overall, the top-down approach of implementing OMT in prisons in the federal state of NRW was effective.
Sections du résumé
BACKGROUND
Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Especially, under the condition of imprisonment, OMT is a preventive measure regarding infectious diseases such as hepatitis C. However, only a minority of prisoners with OUD are currently in OMT in numerous countries. In 2009, the Ministry of Justice of the federal state of North Rhine-Westphalia (NRW), Germany, launched the process of implementing OMT in prisons with various elements (e.g. development of recommendations regarding the treatment of prisoners with OUD, monitoring the number of prisoners in OMT, education of prison doctors). In the recommendations OMT was defined as the gold standard of treatment of OUD.
METHODS
To assess the effectiveness of the implementation strategy a survey on the prevalence of OMT in prisons in NRW was carried out twice a year by the Ministry of Justice between 2008 and 2016. Participants were prisoners in NRW, Germany. The diagnosis of OUD at admission to prison and the treatment state on survey dates was measured.
RESULTS
The number of prisoners in NRW dropped from 17,301 in 2008 to 16,432 in 2016. In the same period, the number of prisoners with OUD (mainly males) dropped from 4201 persons to 3650 persons and the number of prisoners in OMT increased from 139 persons (3.3%) to 1415 (38.7%) persons.
DISCUSSION
Currently, the percentage of prisoners with OUD in OMT in NRW is almost reaching the treatment rate outside prisons in Germany (45-50%). However, after release from prison there is still a high risk for a discontinuation of OMT.
CONCLUSIONS
Overall, the top-down approach of implementing OMT in prisons in the federal state of NRW was effective.
Identifiants
pubmed: 32156295
doi: 10.1186/s13011-020-00262-w
pii: 10.1186/s13011-020-00262-w
pmc: PMC7065365
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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