Buprenorphine: Helping Prison Inmates to Stay Away from Illegal Drugs

Last year, New South Wales Corrective Services injected about 900 prison inmates a month with a view to keeping them away from illegal drugs.

Injecting inmates with an opioid called Buprenorphine, or ‘Bupe’, is intended to help inmates who have a dependency on heroin and other opioids – such as codeine, fentanyl, morphine and methadone.

The initiative follows a ‘successful’ clinical trial by the Justice Health and Forensic Mental Health Network.

Prison officer detained

But the well-meaning programme has had unintended consequences, with reports of inmates threatening and even assaulting prison staff to gain access to the drug.

Recently, a prison inmate reportedly took a prison officer hostage in a facility on the mid-North Coast, only hours after he was rejected from the Opioid Agonist Treatment (OAT) programme, demanding to be put on it.

Reducing drug trade

Buprenorphine is an addictive drug administered into the bloodstream via injection, inducing a high that lasts about a month.

This, in theory, reduces the prospects of inmates using other types of drugs, and the injection method is meant to prevent the trading of Bupe itself in other forms including pills, skin patches or implants.

Bupe strips are one of the most commonly smuggled items into NSW prisons, with black market pricing skyrocketing during the COVID-19 pandemic last year.

Effects of Bupe

A spokesperson for the Justice Health and Forensic Mental Health Network told media that the long-lasting effects of the injection help patients to feel more stable, because it’s slow-release, and results in better safety, and better patient care within the prison environment.

Inmates retain the right to adequate healthcare, including access to effective treatments for drug dependence and so it begs the question whether those with serious drug dependency should be, or even can be, effectively treated in prison, or if they’d have a better chance of recovering from addiction in a specialist treatment facility.

Drug dependency in prison

The most recent figures available from NSW Corrective services suggest that:

• 73 percent of males and 77 percent of females reported using illicit drugs in the six months prior to their current criminal offence
• Use of heavy drugs, (such as heroin, amphetamine or cocaine) in the six months prior to their current prison episode was reported by 48 percent of male prisoners and 62% percent of female prisoners.

Drug dependency and crime

Researchers around the world have conducted hundreds of studies into the link between drug addiction (as well as alcohol addiction) and crime and subsequent imprisonment; as users commit offences such as drug supply and property crimes such as breaking and entering or robbery in order to support their habits.

This is an incredibly complex problem that cannot be divorced from the way Australia deals with drug-related crimes.

The cost of the war against drugs

Enforcing the decades-old war against drugs costs the Australian economy hundreds of millions of dollars every year, through law enforcement and imprisonment costs, as well  as the economic cost of sigmatising and alienating users, rather than supporting them by recognising drug use as a health issue rather than a criminal problem.

By comparison, very little is spent on prevention and treatment, despite the fact that many Australians are now more supportive of the idea that drug dependency should be treated as a health matter.

Most experts have been in agreement on this for a number of decades, asserting that  drug dependency needs to be properly addressed, not in prisons, but in facilities where those who are dependent are given the very best chance possible to turn their lives around before being reintegrated into society.

Drug law reform

In Australia, there have long been calls for a fundamental rethink of drug policy, including a robust discussion about legalisation and decriminalisation.

But very little changes, despite the research and despite the positive experience of countries such as Portugal which decriminalised all illicit substances, from marijuana to crystal methamphetamine and heroin in 2001, and reformed its drug laws.

Such has been the success of Portugal’s model that more than 40 countries around the world have used its policies to shape their own, making decisions to significantly reduce the types of drug offences that result in a prison sentence, and investing heavily in treatment facilities and prevention programmes to treat addiction and reduce re-offending.

Drug courts

Specialist Drug Courts – which operate in Victoria, New South Wales, South Australia, Queensland and Western Australia – which can order drug-dependent offenders to undergo two years of drug treatment rather than imprisonment, as well as drug diversion programs, in which people caught possessing a small amount of drugs are cautioned or sent for treatment rather than being charged, have shown great success in reducing re-offending. But they deal with only a small percentage of offenders.

By and large, the NSW prison population is made up of people who have serious issues with substance abuse.

Impact of imprisonment

It’s also no secret that illicit drugs and alcohol are costly behind bars if they can be obtained which means that people with dependency will often end up finding themselves in debt and/or unable to find gainful employment upon release as a result of their criminal records.

Even if programmes such as the Justice Health and Forensic Mental Health Network’s Opioid Agonist Treatment (OAT) does have some success in helping inmates to manage their opioid addiction, there’s a reasonable chance that, in an environment surrounded by users (not all of whom can be treated by the program) they will end up dependent on something else, perpetuating the never-ending cycle of dependency and crime, turning the justice system into a revolving door.