Effect of prison-based opioid substitution treatment and post-release retention in treatment on risk of re-incarceration
Effect of prison-based opioid substitution treatment and post-release retention in treatment on risk of re-incarceration
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DOI：
10.1111/j.1360-0443.2011.03618.x
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发表时间：
2012-02-01
期刊：
影响因子：
6
通讯作者：
Dolan, Kate
中科院分区：
文献类型：
--
作者：
Larney, Sarah;Toson, Barbara;Dolan, Kate
使用海洛因的人经常被多次监禁。减少这一群体的再监禁对于减少与监禁有关的健康风险和惩教管理费用都很重要。监狱中的阿片类药物替代治疗（OST）可能有助于减少再监禁，但关于这一主题的研究结果好坏参半。在本研究中，我们考察了在监狱和释放后的OST对再监禁的影响。设计纵向队列研究。在澳大利亚新南威尔士州招募的375名男性海洛因使用者的队列中，OST和监禁的数据被联系起来。数据为1997年6月1日至2006年12月31日期间的数据。使用复发事件生存分析模型检查再监禁。模型1检验了刑满释放时OST状态（即释放当天正在接受治疗与未接受治疗）对再监禁的影响。模型2考虑了释放后在OST中停留对再监禁风险的影响。调查结果：90%的参与者在第一次观察释放后再次被监禁。入狱前使用可卡因与再次入狱的平均风险增加13%有关。在释放时仅仅处于OST和再次监禁的风险之间没有显著的联系；然而，在考虑释放后滞留治疗的模型中，参与者在治疗期间再次入狱的平均风险降低了20%。在澳大利亚新南威尔士州，出狱后的阿片类药物替代治疗使重新入狱的平均风险降低了五分之一。
Aims People who use heroin are frequently incarcerated multiple times. Reducing re-incarceration of this group is important for reducing both health risks associated with incarceration and the costs of correctional administration. Opioid substitution treatment (OST) in prisons may help to reduce re-incarceration, but research findings on this topic have been mixed. In this study, we examined the effect of OST in prison and after release on re-incarceration. Design Longitudinal cohort study. Setting, participants and measurements Data on OST and incarceration were linked for a cohort of 375 male heroin users recruited originally in prisons in New South Wales, Australia. Data were linked for the period 1 June 1997-31 December 2006. Re-incarceration was examined using recurrent-event survival analysis models. Model 1 examined the effect of OST status at release from prison (i. e. in treatment versus out of treatment on the day of release) on re-incarceration. Model 2 considered the effect of remaining in OST after release on risk of re-incarceration. Findings Ninety per cent of participants were re-incarcerated following their first observed release. Pre-incarceration cocaine use was associated with a 13% increase in the average risk of re-incarceration. There was no significant association between simply being in OST at the time of release and risk of re-incarceration; however, in the model taking into account post-release retention in treatment, the average risk of re-incarceration was reduced by 20% while participants were in treatment. Conclusions In New South Wales, Australia, opioid substitution treatment after release from prison has reduced the average risk of re-incarceration by one-fifth.