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Article
Title (Guideline ´Medicinal care for drug addicts in penal institutions´) 
Author Westra Michel, de Haan Hein A, Arends Marleen T, van Everdingen Jannes J E, Klazinga Niek S  
Article Information Abstract
Publication Nederlands tijdschrift voor geneeskunde  In the Netherlands, the policy on care for prisoners who are addicted to
opiates is still heterogeneous. The recent guidelines entitled
'Medicinal care for drug addicts in penal institutions' should
contribute towards unambiguous and more evidence-based treatment for
this group. In addition, it should improve and bring the care
pathways within judicial institutions and mainstream healthcare more
into line with one another. Each rational course of medicinal
treatment will initially be continued in the penal institution. In
penal institutions the help on offer is mainly focused on abstinence
from illegal drugs while at the same time limiting the damage caused to
the health of the individual user. Methadone is regarded at the first
choice for maintenance therapy. For patient safety, this is best given
in liquid form in sealed cups of 5 mg/ml once daily in the morning.
Recently a combination preparation containing buprenorphine and naloxone
- a complete opiate antagonist - has become available. On discontinuation
of opiate maintenance treatment intensive follow-up care is necessary.
During this period there is considerable risk of a potentially lethal
overdose. Detoxification should be coupled with psychosocial or
medicinal intervention aimed at preventing relapse. Naltrexone is
currently the only available opiate antagonist for preventing relapse.
In those addicted to opiates, who also take benzodiazepines without any
indication, it is strongly recommended that these be reduced and
discontinued. This can be achieved by converting the regular dosage
into the equivalent in diazepam and then reducing this dosage by a maximum
of 25% a week.


Reference BUPP10084 
Year 2009 
Logged 10/02/2010 
Volume 153 
Part  
Pages A726 
ISSN 1876-8784 
Keywords  
Comparison Drug  
Language Dutch 

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