A randomised controlled trial of methadone maintenance treatment versus wait list control in an Australian prison system

• Published in: Drug and alcohol dependence Vol. 72; no. 1; pp. 59 - 65
• Main Authors: Dolan, Kate A., Shearer, James, MacDonald, Margaret, Mattick, Richard P., Hall, Wayne, Wodak, Alex D.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 24.10.2003; Elsevier Science
• Subjects: Acquired Immune Deficiency Syndrome; Adult; Australia; Australia - epidemiology; Biological and medical sciences; Catchment Area (Health); Desintoxication. Drug withdrawal; Drug Abuse; Drug Injection; Female; Follow-Up Studies; Hepatitis C; Heroin Dependence - rehabilitation; HIV; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Injections; Male; Medical sciences; Methadone; Methadone - therapeutic use; Narcotics - therapeutic use; Prisoner; Prisoners; Prisoners - statistics & numerical data; Prisons; Program Evaluation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Randomised controlled trial; Randomized controlled trials; Treatment Programs; Treatments; Tropical medicine; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Australia; Oceania; Prisoner; Injections; Methadone; HIV; Hepatitis C; Randomised controlled trial; Performance evaluation; Intravenous administration; Hepatic disease; Opiates; Prison(building); Therapeutic schedule; Transmission from man to man; Biological contamination; Heroin; Viral hepatitis C; Human; Immunopathology; Drug addiction; Statistical analysis; Poison withdrawal; Illicit drug; Retroviridae; AIDS; Injection; Immune deficiency; Lentivirus; Infection; Virus; Treatment; Viral disease; Risk factor; Checklist; Digestive diseases; Human immunodeficiency virus; Comparative study
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/S0376-8716(03)00187-X

Objectives: The aim was to determine whether methadone maintenance treatment reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners. Methods: All eligible prisoners seeking drug treatment were randomised to methadone or a waitlist control group from 1997 to 1998 and followed up after 4 months. Heroin use was measured by hair analysis and self report; drugs used and injected and syringe sharing were measured by self report. Hepatitis C and HIV incidence was measured by serology. Results: Of 593 eligible prisoners, 382 (64%) were randomised to MMT ( n=191) or control ( n=191). 129 treated and 124 control subjects were followed up at 5 months. Heroin use was significantly lower among treated than control subjects at follow up. Treated subjects reported lower levels of drug injection and syringe sharing at follow up. There was no difference in HIV or hepatitis C incidence. Conclusions: Consideration should be given to the introduction of prison methadone programs particular where community based programs exist.