Abstract
The provision of substitute medication (methadone) in prison is recommended by the Advisory Committee on the Misuse of Drugs for opiate dependent prisoners undergoing short to medium term sentences. In practice the provision of methadone varies greatly between prisons. To date most injecting drug users entering the prison system have been sentenced for short periods. A change in the law relating to persistent burglary, which came into force in December 1999, may alter this pattern. Mandatory 3-year sentencing may result in an increase in the numbers of injecting drug users imprisoned for longer periods. Injecting behaviour in prison settings carries risk of harm to the individual and to others. Even though injecting is less frequent in such a setting the risks taken in prison by injecting drug users can be amplified. This paper reviews the literature on prison injection and the provision of substitute prescribing in the light of the recent sentencing changes.