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National consensus statement on opioid agonist treatment in custodial settings
Jocelyn Chan1,2,3, Jon Cook2,4, Michael Curtis1,3
1Burnet Institute, Melbourne, VIC.
The Medical Journal of Australia
|March 2, 2025
Summary
Opioid agonist treatment (OAT) in prisons needs improvement. This study provides 19 recommendations for better OAT access and continuity, aiming to reduce overdose deaths for incarcerated individuals.
Area of Science:
- Public Health
- Addiction Medicine
- Criminal Justice Health
Background:
- Opioid use disorder is common in incarcerated populations, leading to high overdose risks.
- Opioid agonist treatment (OAT) is effective but access in prisons is inconsistent.
- There's a national policy gap regarding OAT in Australian prisons.
Purpose of the Study:
- To develop evidence-based recommendations for optimizing OAT in Australian prisons.
- To improve the quality, consistency, and continuity of OAT for incarcerated individuals.
- To address the leading cause of death post-release: overdose.
Main Methods:
- A modified Delphi study was conducted with a national multidisciplinary expert panel.
- 19 recommendations were developed covering five core domains.
- Recommendations were finalized in July 2024.
Main Results:
- Recommendations address OAT induction/continuation, administration, and community transition.
- Key findings include prompt opioid withdrawal management and linkage to community OAT.
- Emphasis on organizational support, funding, and monitoring is crucial.
Conclusions:
- Implementing these recommendations will enhance OAT quality and consistency.
- Improved OAT provision is vital for better health outcomes and reduced overdose deaths.
- This consensus statement provides best practice standards for OAT in Australian prisons.
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