Associate Professor Peter Higgs, Lisa Kennedy, Shelley Walker
Opioid dependence is common among incarcerated individuals, and opioid replacement therapy (ORT) has been shown to assist with opioid withdrawal and reduce or prevent further health issues, premature mortality, and re-offending post release. Despite this, in the immediate post-release period ORT retention rates have been found to drop by roughly 20% (Gisev et al., 2015).
The risk of mortality for incarcerated individuals increases proportionately immediately after their release from prison, with drug related harms a common cause. Previous studies have found that relapse to opioid dependence post-release generally occurs within three months, however this can be as short as within one month of release, especially if preventative measures such as ORT programs are not accessible (Kinlock et al., 2008). Drug related mortality is more prevalent in the two weeks after release than in the following 10 weeks post-release, however this risk remains elevated all through this period (Forsyth et al., 2018).
At current in Australia, incarcerated individuals are able to participate in ORT programs at no cost to them. In Victoria, individuals over the age of 19 may also continue being prescribed and then with ORT drugs (methadone or suboxone) for four weeks at no cost to them. After this period of time the individual must pay a daily dispensing fee to the pharmacy (Justice Health, 2015). The average daily dispensing fee charged by pharmacies in Victoria for ORT is $4.65 however it can be as high as $10. With most program participants (~85%) relying on Government support payments, affordability is a major concern for ensuring program retention (Chalmers & Ritter, 2012).
Using in depth interviews to explore the lived experience of individuals using ORT while incarcerated and post-release, and to better understand the impact of the fully subsidised ORT program in the 4 weeks post release period and beyond.
This study will give a voice to a group of people who are not usually heard, it provides an opportunity to gain a deeper understanding of their lived experience of engaging with ORT in prison and in the immediate period after release.
This study has the potential to inform future policies that relate to the provision of ORT for people in prison and then after their release.
Participants will be recruited from the SuperMIX cohort, established, and conducted by the Burnet Institute.
Semi-structure qualitative interviews will be conducted to explore the lived experience of ORT use pre and post release from prison. Participants will have been released from prison within the last 24 months, served a minimum sentence of 3 months, were being dosed with ORT during their incarceration and were anticipating ORT program participation after their release from prison. This study will focus on the pre- and post-release period specifically pertaining to challenges and benefits experienced by participants, including the transitional phase from prison based to community ORT programs. As data emerges from semi-structured interviews it will be analysed thematically.
This research project aims to further understand the lived experience of ORT participation and potential impacts on treatment continuation post-release from prison.
Further insights into the lived experience of individuals can improve the understanding of the 4-week subsidised treatment program and its effectiveness in treatment retention and inform policy and practice.
For more information relating to this project, please contact Peter Higgs: