People released from prison are more likely to overdose & die in the weeks immediately following release
For those who use opioids, overdose is common, both for those who use and those around then (family and friends) and is the lead causation of death for this population (Degenhardt et al., 2011). Worldwide opioid overdoses are on the rise in Australia, U.S, Canada, and the U.K (HRI, 2016). 70,000 people die from opioid overdose each year according to the World Health Organisation (WHO, 2014).
Of particularly high risk are people recently released from correctional settings. Risk of overdose death increases by three to eightfold in the two weeks following release from prison, in comparison to times of freedom (Merrall et al., 2010).
Research consistently highlights the importance of expanding take home naloxone (THN) for this high-risk group (Binswanger et al., 2007; Clark et al., 2014; Farrell & Marsden, 2008; Merrall et al., 2010).
Estonia, Norway, Spain, and parts of the United Kingdom, Canada and the United States (Clear, 2015; HRI, 2016; Information Services Division, 2015; Public Health Wales, 2015) have all, to some extent, introduced THN for those leaving custody, however the research is slim on how much of an impact on this population this harm reduction program has had.
Naloxone is a short-acting opioid antagonist that reverses respiratory depression in an opioid overdose.
By supplying those that have a history of opioid use with THN and clean sterile “fixing kits” it could be argued would be not only lifesaving if also provided with a short educational session to how to administer the THN, but also an opportunity to use the short time to remind the individual about harm reduction service and practices for once they are given their liberty, such as not using alone and halving their shot due to decreased tolerance for the drug to ensure that the cost to society and more importantly to the individual and their community is mitigated.
What is the point in housing someone in prison, at an approximate cost to Australia’s taxpayers of $302 per day if someone is just going to overdose in the first week of their release? According to the National Drug and Alcohol Research Centre (NDARC) the cost to Australia of opioid related deaths is an average of $15.7 billion dollars and 2203 preventable deaths per year. In a research project run from a Victorian Men’s Correctional facility, on being offered THN on release; 81% of participants, were willing to take THN training prior to release, 94% were willing to resuscitate a friend using THN if they were trained (94%). The study’s conclusion was that male prisoners in Victoria with a history of regular injecting drug use (IDU) were overwhelmingly willing to participate in THN training prior to release (Curtis et al., 2018).
Because of the loss of lives, the great cost to Australian society not only from premature deaths that could have been prevented, but also the costs to the Australian public (see above), THN is now freely available from Needle and Syringe Programs (NSP’s), hospitals, pharmacy’s, with and without a prescription!
Please see the link here to find out where YOU can access Naloxone in your state.
https://www.health.gov.au/initiatives-and-programs/take-home-naloxone-pilot/where-to-access-naloxone
Harm Reduction Info For those leaving Correctional Facilities
Quick Guide to Safer Injecting
(https://www.crcnsw.org.au/wp-content/uploads/2016/10/gettingout-guide-to-surviving.pdf)
Be aware that people who’ve recently left prison have a high risk of overdose!
Reduce the risk of overdose by:
- Not mixing drugs
- Testing with smaller amounts and going slow
- Not using alone
- Learning mouth-to-mouth first aid.
- Avoid viruses such as HIV, Hep B and Hep C by:
- Using a clean fit every time
- Using Needle and Syringe Programs (NSPs)
- Not sharing any injecting equipment.
- Making sure you have Narcan on you every time you use!
Please see the link here to find out where YOU can access Naloxone in your state=
https://www.health.gov.au/initiatives-and-programs/take-home-naloxone-pilot/where-to-access-naloxone
References-
https://ndarc.med.unsw.edu.au/news/cost-opioid-use-australia-157-billion-and-2203-deaths
https://adf.org.au/insights/naloxone-saves/
https://minerva-access.unimelb.edu.au/bitstream/handle/11343/271272/PMC6497216.pdf