Prisons: low availability of hepatitis C treatment
Prisoners report higher lifetime rates of drug use and more harmful patterns of use (including injecting) than the general population, making prisons an important setting for drug-related interventions. Many prisoners have complex healthcare needs, and assessment of drug use and drug-related problems is an important part of the health screening at prison entry in many countries.
Two important principles for the implementation of health interventions in prison are equivalence with provision in community settings and continuity of care after prison release. The availability of opioid substitution treatment in prisons is reported by 28 of the 30 countries monitored by the EMCDDA. Detoxification, individual and group counselling, and therapeutic communities or special inpatient wards are available in most countries. Many European countries have established interagency partnerships between prison health services and providers in the community, in order to facilitate delivery of health education and treatment interventions in prison and to ensure continuity of care upon prison entry and release.
Many prisoners have complex healthcare needs
Infectious diseases testing (HIV, HBV, HCV) is available in prisons in most countries, although the provision of hepatitis C treatment is rare. Hepatitis B vaccination programmes are reported to exist in 16 countries. The provision of clean injecting equipment is less common, with only 4 countries reporting the existence of syringe programmes in this setting.
Preparation for prison release, including social reintegration, is carried out in most countries. Programmes to prevent the risk of drug overdose, particularly high among opioid injectors in the period after leaving prison, are reported in 5 countries and include training and information and the provision of naloxone upon prison release.