The health needs of people leaving prison with a history of methamphetamine and/or opioid use

Craig Cumming; Stuart A Kinner; Rebecca McKetin; Ian Li; David B Preen

doi:10.1111/dar.13636

The health needs of people leaving prison with a history of methamphetamine and/or opioid use

Drug Alcohol Rev. 2023 May;42(4):778-784. doi: 10.1111/dar.13636. Epub 2023 Mar 14.

Authors

Craig Cumming¹, Stuart A Kinner^{2

3

4

5}, Rebecca McKetin⁶, Ian Li⁷, David B Preen¹

Affiliations

¹ Centre for Health Services Research, School of Population and Global Health, University of Western Australia, Perth, Australia.
² Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
³ Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
⁴ Griffith Criminology Institute, Griffith University, Brisbane, Australia.
⁵ School of Population Health, Curtin University, Perth, Australia.
⁶ National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
⁷ School of Population and Global Health, University of Western Australia, Perth, Australia.

Abstract

Introduction: Methamphetamine use is more common than opioid use among prison entrants in some countries, including Australia, yet most research and policy focuses on opioid use. This suggests that traditional opioid-focused interventions are no longer appropriate for the majority of this group in countries such as Australia. To inform policy and practice, we compared socio-demographic characteristics and health needs of people leaving prison with a history of methamphetamine use and/or opioid use.

Methods: A cross-sectional survey of incarcerated adults administered the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test was used to identify moderate-/high-risk methamphetamine use (n = 909), opioid use (n = 115) or combined methamphetamine/opioid use (n = 356) before incarceration. We compared groups using modified log-linked Poisson regression with robust error variance.

Results: Compared to the opioid-only group, the methamphetamine-only group were: significantly more often aged <25 years; significantly more likely to identify as Indigenous; significantly less likely to have a history of prior incarceration, drug injection or overdose. A significantly lower proportion of methamphetamine-only and methamphetamine-and-opioid participants self-reported current hepatitis C infection compared to opioid-only participants. A majority of participants in all groups screened positive for current psychological distress according to the K10.

Discussion and conclusions: People leaving prison with a history of methamphetamine use differ from opioid users with respect to demographics, patterns of substance use and related health concerns. Treatment and harm reduction efforts for people who experience incarceration must respond to patterns of drug use in this population, and invest at scale in coordinated, continuous services for co-occurring substance use and mental health problems.

Keywords: harm reduction; methamphetamine; opioid; prisons; substance-related disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Analgesics, Opioid / therapeutic use
Cross-Sectional Studies
Humans
Methamphetamine*
Opioid-Related Disorders* / drug therapy
Prisoners*
Prisons

Substances

Methamphetamine
Analgesics, Opioid