Opioid Diversion in Prison

Researchers at Spectrum CIC have collaborated with partners at Leeds and Huddersfield Universities to undertake a systematic review of the literature pertaining to the risk of diversion of prescribed opioids in prison settings. This remains a significant problem facing healthcare staff. Key findings were that, internationally, there is variation between countries in the type of opioid diverted. For example, in the UK, diversion of sublingual buprenorphine is a significant problem, whereas in the USA a practice of oxycontin abuse was identified. Whilst prison is a time when many drug users stop injecting, ongoing drug use remains a significant problem. Prisoners report boredom as a trigger for prescription opioid abuse in prison. Significant pressures upon prisoner officer time emerged as a significant issue in reducing the potential to monitor the appropriate use of prescribed medication.

Regarding addressing this issue in the future, new products have either been launched, or are in development. For example, a rapidly dissolving buprenorphine preparation has just been launched in the UK, and an injectable buprenorphine depo preparation is in development. Trends in drug abuse in prisons are subject to rapid change according to availability of a particular drug. For example, there is increasing anecdotal UK evidence of a move away from prescription opioid abuse to prescription analgesic abuse, with the drugs pregabalin and gabapentin being implicated. Our research highlights the need for healthcare and discipline staff to work together to develop systems to minimise the risk of prescribed medication.

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