Commentary on Larney (2010): a call to action-opioid substitution therapy as a conduit to routine care and primary prevention of HIV transmission among opioid-dependent prisoners.
Commentary on Larney (2010): a call to action-opioid substitution therapy as a conduit to routine care and primary prevention of HIV transmission among opioid-dependent prisoners.
复制标题
Larney 评论（2010 年）：呼吁采取行动阿片类药物替代疗法，作为阿片类药物依赖囚犯中艾滋病毒传播的常规护理和初级预防的渠道。
DOI：
10.1111/j.1360-0443.2009.02893.x
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Springer,SandraA
中科院分区：
文献类型：
--
作者：
Springer,SandraA
Larney [1] should be commended for delineating clearly the serious deficits not only in the paucity of available opioid substitution treatment (OST) in prisons, but also on the limited critical evaluation of such programs within the literature to date. The few available studies without significant methodological flaws confirm OST conferring positive public health outcomes by reducing intra-prison injection drug use (IDU) and IDU-related human immunodeficiency virus (HIV) risk behavior. While this review focused specifically on OST's impact on HIV risk behaviors, the benefit of providing this medically indicated and evidencebased treatment goes well beyond this narrowly defined outcome.As noted by Larney [1], flawed methodological issues and/or low retention hamper interpretation of existing data which may contribute, in part, to the incredibly poor wide-scale implementation of OST in prison, despite its documentation as an evidence-based treatment outside the criminal justice system. What data might improve current policies to increase provision of OST within prisons? First, HIV risk behaviors within prisons need to be assessed in prisoners on OST who are HIV-infected. Numerous studies document that IDU is correlated with increased HIV incidence in prisons through syringe and needle sharing in several countries, including Thailand [2], Canada [3], the United States [4], Russia, Brazil, Iran, Australia, Lithuania, Russia and the United Kingdom [5]. The limited use of OST among incarcerated populations within the United States is a travesty, given that HIV prevalence is three times greater in incarcerated populations when compared to the community [6], with upwards of 50% meeting DSM-IV criteria for opioid abuse/dependence [7]. The disparity between OST need and implementation is unambiguous, and results in significant public health harm despite both the World Health Organization (WHO)[8] and the National Institute of Drug Abuse (NIDA) calling for widespread institution of OST in prison and jail settings [9]. Unfortunately, provision of OST in the criminal justice systems in the United States and elsewhere or the rest of the world has improved little in recent years.
