Continuity of opioid substitution treatment (OST) from prison to community to reduce post-release mortality — evidence summary

Summary of the evidence

Rating:
Beneficial

Opioid substitution treatment was found in a systematic review (ECDC/EMCDDA, 2018) to be effective in:

  • reducing post-release mortality.

One cohort study (Degenhardt et al., 2014) enrolling N=16453 people released from prison 60161 times (all opioid dependent people who entered OST between 1985 and 2010 and were released from prison at least once between 2000 and 2012 in Australia) showed that those continuously retained in OST after being released from prison (continuity of care):

  • had a reduced risk of mortality by 75% (adjusted hazard ration=0.25, 95 % CI 0.12 to 0.53).

One RCT (Dolan et al., 2005, cited in EMCDDA, 2010) suggests that retention in MMT in prison settings is associated with:

  • reduced mortality from all causes (OR 0.54, 95 % CI 0.20 to 1.43);
  • reduced mortality for overdose.

Details

Note: this evidence summary is only valid for the outcomes, target groups, settings and substances/patterns of use described below.

Name of response option:
Continuity of treatment from prison to community
Desired outcome(s):
reduce mortality
Area(s)
Harm reduction
Specific substance or pattern of use:
opioids
Target group(s) or setting(s):
prison