Determining the impact of opioid substitution therapy upon mortality and recidivism among prisoners : a 22 year data linkage study

Prisoners experience high rates of drug dependence, health problems and premature mortality. Without intervention, they often come into further contact with the criminal justice system, creating further health risk. Opioid dependence is common among prisoners, yet treatment with opioid substitution therapy (OST) may reduce or prevent morbidity, mortality and offending. Using retrospective data linkage, this study evaluated engagement with treatment, patterns of offending, incarceration and mortality among opioid-dependent people who received OST in New South Wales, Australia between 1985 and 2010. The results highlight that the prison setting provides an important opportunity to engage people in OST. Notably, OST treatment in prison and immediately post-release was found to be highly protective against mortality both while incarcerated and after release. Considering some of the known benefits of OST, this study provides strong evidence to support the value of OST programs within the criminal justice system.