Eligibility for opiate substitution therapy in recently released prisoners with high-risk amphetamine use, and their perceptions of its effectiveness

ABSTRACT

Introduction and Aim: The harmful consequences of amphetamine (including methamphetamine) misuse in Australia and internationally have been well documented. There has been surprisingly little exploration, however, of the role of opiate substitution therapy (OST), an evidence-based harm minimization strategy for opiate dependence, in eligible high-risk amphetamine users. Design and Methods: This survey study explored histories of substance use and dependence, and eligibility for OST, in a group of Queensland adult male ex-prisoners recently released into a residential supported parole program. Results: 57% of participants were identified as high-risk amphetamine (HRA) users. Of these HRA users, 74% were eligible for opiate substitution treatment under current Australian guidelines, and 59% believed that suboxone (buprenorphine and naloxone) maintenance would reduce their risks of going back to prison due to amphetamine use. Discussion and Conclusions: In recently released prisoners with a history of high-risk amphetamine use and opiate dependence, OST may be a strategy to reduce the harms of both opiate and amphetamine use. Further studies are needed to understand poly-drug use in this population, and optimize the safety, effectiveness, and attractiveness of suboxone maintenance for these potential clients.

KEYWORDS:

• Amphetamine misuse
• ADHD
• opiate substitution therapy
• poly-drug use
• prisoners