Continuity of opioid substitution treatment between prison and community in Southeast Asia: a scoping review
Continuity of opioid substitution treatment between prison and community in Southeast Asia: a scoping review
Background: criminalisation of drug use and compulsory detention has largely characterised the Southeast Asia region's response to people who use drugs. Whilst access to and provision of healthcare for people living in prison are mandated by international human rights standards, many opioid dependent people living in prison continue to lack access to opioid substitution treatment (OST) during incarceration, and face uncertainties of continuity of care beyond the prison gate.
Methods: a scoping review using Arksey and O'Malley's framework mapped what is currently known about the continuity of OST post-release in Southeast Asia, with a focus on the three countries (Indonesia, Malaysia, Vietnam) that provide OST in at least one prison. A multi-lingual systematic search (English, Malay, Indonesian, Vietnamese) on Medline, CINAHL, Scopus, Web of Science, PsycINFO and the Cochrane Library collected and reviewed extant relevant published empirical and grey literature including government reports between 2011 and 2021. Of the 365 records found, 18 were eligible for inclusion following removal of duplicates and application of exclusion criteria. These records were charted and thematically analysed.
Results: three main themes were generated: Facilitators of post release continuity of care, Barriers to post release continuity of care and Therapeutic considerations supporting post release continuity of care. When individual and structural gaps exist, disruptions to continuity of OST care post release are observed. Adequate methadone dosage of >80mg/day appears significantly associated with retention in post-release OST.
Conclusions: the review highlights the facilitators, barriers and therapeutic considerations of continuity of care of OST between prison and community for people living in prisons from Indonesia, Malaysia and Vietnam. Improving community services with family support are key to supporting continued OST adherence post release along with reducing societal stigma towards people who use drugs and those entering or leaving prison. Further efforts are warranted to ensure parity, quality and continuity of OST care post release.
Humans, Opiate Substitution Treatment, Opioid-Related Disorders/rehabilitation, Prisoners, Prisons, Vietnam, Continuity of care, People living in prison, Opioid use disorder, Opioid substitution treatment, OST, Southeast Asia, Post release, Drug dependence
Loh, Debbie Ann
009a46e0-1869-4496-a6c3-cbf2a0e92b07
Plugge, Emma
b64d2086-6cf2-4fae-98bf-6aafa3115b35
Van Hout, Marie-Claire
65aa6f90-32e2-486a-8d78-20ba9d590526
February 2023
Loh, Debbie Ann
009a46e0-1869-4496-a6c3-cbf2a0e92b07
Plugge, Emma
b64d2086-6cf2-4fae-98bf-6aafa3115b35
Van Hout, Marie-Claire
65aa6f90-32e2-486a-8d78-20ba9d590526
Loh, Debbie Ann, Plugge, Emma and Van Hout, Marie-Claire
(2023)
Continuity of opioid substitution treatment between prison and community in Southeast Asia: a scoping review.
International Journal of Drug Policy, 112, [103957].
(doi:10.1016/j.drugpo.2023.103957).
Abstract
Background: criminalisation of drug use and compulsory detention has largely characterised the Southeast Asia region's response to people who use drugs. Whilst access to and provision of healthcare for people living in prison are mandated by international human rights standards, many opioid dependent people living in prison continue to lack access to opioid substitution treatment (OST) during incarceration, and face uncertainties of continuity of care beyond the prison gate.
Methods: a scoping review using Arksey and O'Malley's framework mapped what is currently known about the continuity of OST post-release in Southeast Asia, with a focus on the three countries (Indonesia, Malaysia, Vietnam) that provide OST in at least one prison. A multi-lingual systematic search (English, Malay, Indonesian, Vietnamese) on Medline, CINAHL, Scopus, Web of Science, PsycINFO and the Cochrane Library collected and reviewed extant relevant published empirical and grey literature including government reports between 2011 and 2021. Of the 365 records found, 18 were eligible for inclusion following removal of duplicates and application of exclusion criteria. These records were charted and thematically analysed.
Results: three main themes were generated: Facilitators of post release continuity of care, Barriers to post release continuity of care and Therapeutic considerations supporting post release continuity of care. When individual and structural gaps exist, disruptions to continuity of OST care post release are observed. Adequate methadone dosage of >80mg/day appears significantly associated with retention in post-release OST.
Conclusions: the review highlights the facilitators, barriers and therapeutic considerations of continuity of care of OST between prison and community for people living in prisons from Indonesia, Malaysia and Vietnam. Improving community services with family support are key to supporting continued OST adherence post release along with reducing societal stigma towards people who use drugs and those entering or leaving prison. Further efforts are warranted to ensure parity, quality and continuity of OST care post release.
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e-pub ahead of print date: 22 January 2023
Published date: February 2023
Additional Information:
Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors wish to thank the authors referenced in this review including UNODC Headquarters in Vienna and the regional office in Thailand for their persistent efforts, commitment and contribution to understanding the challenges and progress in SEA and advocating for harm reduction for PWUD and PWID in the region.
Publisher Copyright:
© 2023 The Author(s)
Keywords:
Humans, Opiate Substitution Treatment, Opioid-Related Disorders/rehabilitation, Prisoners, Prisons, Vietnam, Continuity of care, People living in prison, Opioid use disorder, Opioid substitution treatment, OST, Southeast Asia, Post release, Drug dependence
Identifiers
Local EPrints ID: 485299
URI: http://eprints.soton.ac.uk/id/eprint/485299
ISSN: 0955-3959
PURE UUID: d4c3615e-5d95-422d-b3b3-d19f1e4e93f0
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Date deposited: 04 Dec 2023 17:35
Last modified: 18 Mar 2024 03:57
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Author:
Debbie Ann Loh
Author:
Marie-Claire Van Hout
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