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Multicenter Study
. 2018 Sep 21;15(1):48.
doi: 10.1186/s12954-018-0255-5.

Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use

Michael Curtis  1 , Paul Dietze  2   3 , Campbell Aitken  4   3 , Amy Kirwan  2 , Stuart A Kinner  3   5   6 , Tony Butler  7 , Mark Stoové  2   3
Affiliations
Multicenter Study

Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use

Michael Curtis et al. Harm Reduct J. .

Abstract

Background: Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia.

Methods: The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration. We asked four questions regarding THN during the pre-release baseline interview, including whether participants would be willing to participate in prison-based THN. We describe responses to these questions along with relationships between before- and during-incarceration factors and willingness to participate in THN training prior to release from prison.

Results: Most participants (81%) reported willingness to undertake THN training prior to release. Most were willing to resuscitate a friend using THN if they were trained (94%) and to be revived by a trained peer (91%) using THN. More than 10 years since first injection (adjusted odds ratio [AOR] 2.22, 95%CI 1.03-4.77), having witnessed an opioid overdose in the last 5 years (AOR 2.53, 95%CI 1.32-4.82), having ever received alcohol or other drug treatment in prison (AOR 2.41, 95%CI 1.14-5.07) and injecting drugs during the current prison sentence (AOR 4.45, 95%CI 1.73-11.43) were significantly associated with increased odds of willingness to participate in a prison THN programme. Not specifying whether they had injected during their prison sentence (AOR 0.37, 95%CI 0.18-0.77) was associated with decreased odds of willingness to participate in a prison THN training.

Conclusion: Our findings suggest that male prisoners in Victoria with a history of regular IDU are overwhelmingly willing to participate in THN training prior to release. Factors associated with willingness to participate in prison THN programmes offer insights to help support the implementation and uptake of THN programmes to reduce opioid-overdose deaths in the post-release period.

Keywords: Injecting drug use; Naloxone; Overdose; Prison.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for the Prison and Transition Health Cohort Study was obtained from the Alfred Hospital Human Research Ethics Committee (79/12) and the Victorian Department of Justice Human Research Ethics Committee (CF/14/10169). All participants provided informed, written consent prior to participation.

Consent for publication

Not applicable.

Competing interests

PD and MS have received investigator-initiated funding from Gilead Sciences and PD has received an untied educational grant from Indivior for work unrelated to this study. PD, SK and MS are NHMRC Senior Research Fellows. The other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. ABS. Prisoners in Australia, 2017: Australian Bureau of Statistics; 2017. [cited 2018 17/03/2018]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4517.0~2017~...
    1. AIHW . The health of Australia’s prisoners 2015. Canberra: Australian Institute of Health and Welfare; 2015.
    1. Carpentier C, Royuela L, Montanari L, Davis P. The global epidemiology of drug use in prison. In: Kinner SA, Rich JD, editors. Drug use in prisoners: epidemiology, implications, and policy responses. Oxford: Oxford University Press; 2017.
    1. Kinner SA, Jenkinson R, Gouillou M, Milloy MJ. High-risk drug-use practices among a large sample of Australian prisoners. Drug Alcohol Depend. 2012;126:156–160. doi: 10.1016/j.drugalcdep.2012.05.008. - DOI - PubMed
    1. Butler T, Callander D, Simpson M. National Prison Entrants' Bloodborne Virus Survey Report 2004, 2007, 2010 and 2013: Kirby Institute (UNSW Australia); 2015.

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