Opioid substitution treatment in prison and post-release : effects on criminal recidivism and mortality

More than eight in ten prisoners who use heroin in New South Wales, Australia, will be back in prison within two years of being released. But this rate can be cut by 20 per cent if they leave prison on methadone treatment and stay on it in the community. This was the major finding of a report released today by the National Drug and Alcohol Research Centre at the University of New South Wales.

The researchers studied a group of 375 prisoners for ten years. The study found that heroin dependent ex-prisoners died at six times the rate of males in New South Wales of the same age who had never used heroin. Continuation in methadone treatment reduced the risk of death by around 40 per cent, according to the study.

The study also found that within two years 84 per cent of heroin dependent ex-prisoners were back in prison compared to the state average for all prisoners of 45 per cent. Over the ten year period 99.5 per cent of the group being followed went back to prison on average of 5 times and for an average of three months at a time or three and half years in total. Just being on methadone when released did not reduce the chance of going back to prison but if this treatment was continued into the community then the rate of re-incarceration was reduced by 20 per cent.

It costs about $75,000 to keep someone in prison per year compared to $4,000 to keep them in methadone treatment. There are over 10,000 people in NSW prisons today. This number could be substantially reduced if NSW had more prison inmates starting methadone treatment and continuing that after returning to the community.