Data on drug treatment in prisons is now collected by the National Drug Treatment Monitoring System (NDTMS). Figures for clinical interventions for opioid dependence in prisons for 2013-14 are presented in the following table. Data collection started in 2011-12 but 2013-14 is the first year for which robust and accurate data is available.
National clinical guidance recommends that prisoners on sentences of less than six months receive methadone or buprenorphine maintenance as their first line treatment to enable them to engage in treatment upon release. Most offenders receiving drug treatment in prison are there for three months or less, either serving short sentences or on remand for a few weeks and not in the system long enough to complete a structured drug treatment programme.
The guidance also reflects the drive towards a more recovery-orientated approach and, as a result, unless there are clinical reasons to the contrary, prisoners serving a sentence of more than six months will be expected to work towards becoming drug free.
Prisoners with drug misuse problems present a high risk of suicide and self-harm in the first weeks of custody and are particularly vulnerable to overdose on release. In these circumstances, it is good clinical practice to continue the treatment the prisoner was receiving before arrest, or to prepare them for the treatment they will receive on release. For opiate users, this will often mean that maintenance prescribing is the appropriate treatment response.