METHADONE-MAINTENANCE TREATMENT REDUCES HEROIN INJECTION IN NEW-SOUTH-WALES PRISONS

The purpose of this study was to examine whether methadone maintenance treatment reduces injecting risk behaviour land therefore transmissio n of blood-borne viral infections) among prisoners in New South Wales (NSW), using comparison of retrospective reports of drug use in prison s for people who received standard drug treatment, time-limited methad one treatment and methadone maintenance treatment, The setting for the study was the NSW prison system. One hundred and eighty-five injectin g drug users who had been recently released from NSW prisons were recr uited in 1993, Self-reported drug use and injecting risk behaviour wer e compared in inmates who received standard drug treatment (counsellin g), time-limited methadone treatment and methadone maintenance treatme nt. HIV status was determined by serology, Intervention comprised high and low dose methadone treatment and counselling. The groups were sim ilar in terms of most basic demographic characteristics but subjects w ho had been maintained on methadone reported a significantly lower pre valence of heroin injection, syringe sharing and scored lower on an HI V Risk-taking Behavioural Scale than subjects who received standard dr ug treatment and time-limited methadone treatment, This study suggests that methadone treatment is associated with reduced injecting risk be haviour in prison with adequate (greater than 60 mg) dose and duration in treatment. These treatment conditions are known to increase effect iveness in community-based methadone programmes. Prospective studies a re required to evaluate the effectiveness of methadone programmes in t he prevention of HIV and other blood-borne viral infections among IDU prisoners.