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Table HSR-9. Opioid substitution treatment in prison in EU, Croatia, Turkey and Norway, 2010/2011
| Country | Number of prisoners in OST in 2011 or latest year available | 2010/2011 | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Initiation of OST | Starting from year | Continuation of OST | Starting from year | OST availability in prison 2010 (expert rating) | Total number of prisoners on a given day | clients on a given day | clients in the year | % of prison population in OST | ||||||
| Belgium | Yes | 2004 | Yes | 2004 | No information | 11 382 | 341 | : | (8) | 3% - <10% | ||||
| Bulgaria | Yes | 2008 | Yes | : | : | 9 379 | : | 39 | < 3% | |||||
| Czech Republic | No | Yes | 2006 | (1) | Limited | 21 955 | : | 99 | < 3% | |||||
| Denmark | Yes | 1988 | Yes | : | Full | 3 944 | : | 550 | < 3% | |||||
| Germany | Yes | 1992 | Yes | 1992 | No information | 71 634 | : | 2838 | (14) | 3% - <10% | ||||
| Estonia | Yes | 2008 | Yes | 2009 | Full | 3 470 | : | 118 | < 3% | |||||
| Ireland | Yes | 2000 | Yes | 2000 | Full | 4 352 | 514 | : | ||||||
| Greece | Not available | Not available | (2) | Not available | 11 934 | 0 | 0 | not available | ||||||
| Spain | Yes | 1998 | Yes | : | Full | 75 859 | 7662 | 20452 | (8) | > 10% | ||||
| France | Yes | 1995 | Yes | 1995 | Extensive | 66 925 | 6000 | : | (15) | 3% - <10% | ||||
| Italy | Yes | 1990 | Yes | 1990 | Limited | 68 345 | : | 4457 | (9) | 3% - <10% | ||||
| Cyprus | Not available | Not available | (3) | Not available | 900 | 0 | 0 | not available | ||||||
| Latvia | No | Yes | 2012 | : | 6 778 | 0 | 0 | (16) | < 3% | |||||
| Lithuania | Not available | Not available | Not available | 8 887 | 0 | 0 | not available | |||||||
| Luxembourg | Yes | 2000 | Yes | : | Full | 680 | : | 220 | > 10% | |||||
| Hungary | (Yes) | 2001 | (Yes) | 2001 | (4) | : | 16 459 | 0 | 0 | < 3% | ||||
| Malta | Yes | 1995 | Yes | : | (5) | Limited | 583 | : | 107 | 3% - <10% | ||||
| Netherlands | Yes | 1985 | Yes | : | Extensive | 11 737 | : | 1409 | (8) | 3% - <10% | ||||
| Austria | Yes | 1987 | Yes | 1987 | Full | 8 597 | 816 | : | (18) | 3% - <10% | ||||
| Poland | No | Yes | 2006 | Extensive | 80 728 | : | 283 | < 3% | ||||||
| Portugal | Yes | 1999 | Yes | : | Extensive | 11 613 | 1295 | : | (17) | > 10% | ||||
| Romania | Yes | 2008 | Yes | : | Limited | 28 191 | : | 60 | < 3% | |||||
| Slovenia | Yes | 1995 | Yes | 1995 | Full | 1 351 | : | 560 | (8) | > 10% | ||||
| Slovakia | Not available | Not available | Not available | 10 068 | 0 | 0 | not available | |||||||
| Finland | Yes | 2008 | Yes | : | Rare | 3 316 | 50 | : | < 3% | |||||
| Sweden | Yes | 2006 | Yes | : | : | 6 922 | : | 72 | (10) | < 3% | ||||
| UK England & Wales | Yes | 2006 | Yes | 2006 | 85 862 | : | 30650 | (11) | > 10% | |||||
| UK N Ireland | No | Yes | : | (UK) Full | 1 507 | : | : | (19) | : | |||||
| UK Scotland | Yes | 2003 | Yes | : | 7 996 | 1639 | : | (8), (20) | > 10% | |||||
| Croatia | Yes | 1992 | Yes | 1992 | (6) | Limited | 5 165 | : | 955 | 3% - <10% | ||||
| Turkey | (Yes) | 2010 | (Yes) | 2010 | Not available | 120 391 | 0 | 0 | not available | |||||
| Norway | Yes | 2000 | Yes | 2000 | (7) | Extensive | 3 636 | 167 | : | (12), (13) | 3% - <10% | |||
Notes:
Where data are not available for a country, the table entry is left empty.
(...) indicates that substitution treatment is legally available in the country but there are no reported clients.
Reitox NFPs's expert rating
Full: nearly all prisoners in need would obtain it
Extensive: a majority of prisoners but not nearly all of them would obtain it
Limited: more than a few but not a majority of prisoners would obtain it
Rare: just a few of prisoners would obtain it
(1) OST can be initiated only in rare individual cases.
(2) According to Ministerial Decree, (Y5 69750/ 2003) substitution substances (methadone or buprenorphine) can be administrated for 12 days to drug addicts who are under arrest by police or prosecution agencies and are being taken into custody in correctional institutions, with the precondition that they are already under such treatment, in order to prevent withdrawal symptoms when due to the imprisonment the continuation of the programme in not possible.
(3) Foreseen in Cyprus Action Plan by 2012.
(4) Methadone treatment has to be provided daily at external treatment centres, while Buprenorphine-naloxone treatment can be provided in prisons.
(5) When a person is admitted to prison, an initial medical assessment is done immediately and if the inmate requires methadone, s/he is admitted to the Forensic Unit at Mount Carmel Hospital (psychiatric hospital) for the start of the treatment. Eventually, when the inmate is stabilised and the process of weaning off from methadone is clear, s/he is re-admitted to the prison, where s/he can continue the treatment until the treatment finally ends. Initiation of an OST (mainly methadone) is thus not precisely from the prison system but from the Forensic Unit.
(6) Methadone treatment in prison was introduced in 1992, while Buprenorphine treatment was introduced in 2007.
(7) Initiation of OST has to be carried out by an external regional maintenance treatment provider.
(8) 2010 data.
(9) The number of prisoners in Italy “with drug-related health and social problems”, including people in need of opioid substitution treatment, is 24 008.
(10) Number of prisoners treated in project ITOK (Stockholm) in 2010: personal communication, Swedish NFP, 08 June 2012. Maintenance treatment with methadone and buprenorphine is available at the prisons in Fosie (Malmö), Storboda and Täby in Region Stockholm and Högsbo in Region West.
(11) Number of clients in extended prescribing programmes refers to fiscal year: 1.4.2010 and 31.3.2011.
(12) 2008 data.
(13) Personal communication Odd Hordvin, Norwegian NFP 1 March 2010.
(14) Personal communication Lisa Jakob, German NFP 17 October 2011. The data represents 5 Länder (Sachsen-Anhalt, Baden-Württemberg, Berlin, Hessen & Nordrhein-Westfalen) where a total of 2 838 cases of OST reported in the years 2009-2011 were recorded. The total number of prisoners in these 5 countries is 31 865. The resulting OST rate for the figure is thus 8,90.
(15) Estimate, based on rate of 9% of prisoners in OST, found in study by Michel et al. (2011) http://www.biomedcentral.com/1471-2458/11/400, conducted in 2009. Data were provided by 60% of prisons; average rate of 9% refers to June 2009; coverage varied between 0% to 40% of inmates, depending on the prison.
(16) Under existing law, convicted persons seeking treatment for drug addiction in Latvia may start a self-funded course of treatment, to be provided by an external certified addiction specialist. Drug treatment is not available as part of the medical care provided by the Prison Administration.
(17) Includes clients in methadone, subutex and opioid agonist programmes, 31.12.2011.
(18) Data refer to 1.4.2012.
(19) Number of prisoners in Ireland according to Northern Ireland Prison Service Annual Report.
(20) Number of prisoners in Scotland according to Scottish Government publication for mid-2010.
For further information on the calculations of the rates please see Figure HSR-4.
See also 'General notes for interpreting data' on the Explanatory notes and help page.
Sources:
Standard Table 24 (ST24) on 'treatment availability' submitted by NFPs in 2012.
Structured Questionnaire on 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted by NFPs in 2011.
Reitox National Reports 2011.
Data on number of prisoners: CoE SPACE I Survey 2010, Table 1: Total number of prisoners including pre-trial detainees on 1.9.2010.