Opioid substitution treatment in jail - A practical guide

Whilst Dave makes the most of his few remaining days in paradise, I (Kevin) thought I would discuss a topic I read with interest on yesterdays Daily Dose -

The guide, recently published by BIS-Verlag with the support from WHO and UNODC, aims at providing a reference document supporting prison doctors, prison health care workers, prison administration, NGOs and others in delivering or supporting substitution treatment to opioid dependent prisoners [Connections]

Well, what a step forward! I'd like to talk a little bit about my experiences of substitution treatment in prison. Before I entered jail in early 2003 I was being prescribed a mixture of drugs by my GP. I was on 50ml of methadone, 12x30ml dihydrocodiene and 60ml valium, everyday. On top of this I had recently started to use heroin again.

On entering Parc prison in Bridgend, I applied to see the Doctor. This took around 10 days to happen, during which time I was a right mess! When I got to the medical centre I told the Doctor that I was a heroin addict and had been receiving treatment from my GP. He told me there wasn't anything he could do for me. A bit shocked, I explained what my GP had prescribed me and asked for his help. He laughed in my face. At the time I figured he thought I was lying so I said that he could check it out with my GP. With that he held up a blank piece of A4 and said 'medical report'. He then put it in the shredder!

With that the prison officer took me back to the cell I was living in and that was that. I was ill for the next 2-3 months, suffering a couple of blackouts and the worst detox I have ever gone through. I could not believe it! Does the Hippocratic oath mean nothing?! That was my experience of prison opioid substitution treatment.

Yes of course a practical guide for prison Doctors, nurses etc is a good thing. The guide itself (what I've read of it - well it is quite long!) is coming from the right direction and has solid advice in it. But all of that is for nothing, if the prison Doctor doesn't want to follow it. The guide will just go in the shredder!