MAINTENANCE PROGRAMMES ARE DENIED TO ADDICTED PRISONERS IN VICTORIA

EDITOR - In my role as a peer programme advisor (infection control, harm
minimisation) and as a drugs and alcohol counsellor at a Melbourne centre
with over 700 patients on methadone and 300 on naltrexone I wonder at the
prison system in Victoria.

We have no maintenance program for methadone, no needle exchange, and do
not allow inmates to continue on naltrexone programmes when they enter
prison. But we do provide harm minimisation sessions, mandatory HIV and
hepatitis sessions, and bleach for injecting equipment.

If we are to go some way towards providing similar medical treatment to
that provided in the community we should at least allow prisoners to
continue on methadone and the more recent naltrexone programmes. Some of
our patients who were taking naltrexone when they entered prison were
denied further treatment. What happens if one of these patients lapses and
we have a death from overdose? Is there not a duty of care?

Prisoners' families were funding naltrexone treatment, which constitutes an
abstinence program. Surely this practice should be emulated in prison as
well as the methadone maintenance programmes described by Byrne and Dolan.[1]

Steve Simpson, Counsellor. Barkly Street Medical Centre, 60 Barkly Street,
St Kilda, 3182 Victoria, Australia steve.simpson@maribyrnong.vic.gov.au

[1]Byrne A, Dolan K. Methadone treatment is widely accepted in prisons in
New South Wales. BMJ 1998; 316: 1744.(6 June.)