Page 1576 - Week 04 - Thursday, 7 April 2011
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of opioid pharmacotherapy and compliance with case plans and discharge plans. In responding to this recommendation, a range of actions will be considered. Prisoners on pharmacotherapies could be monitored for three months post release for retention on the program. Any program of this nature would need to consider individual prison choice for post-release monitoring. Post-release monitoring of prisoners who are on psychiatric pharmacotherapy in detention could be carried out through forensic mental health services. Post-release monitoring of prisoners on opioid replacement therapy could be monitored through the AOD sector, including the alcohol and drug program in ACT Health.
There are a number of recommendations that have resourcing implications. These may need to be considered in the budget context. Adding to this, a number of the recommendations need to be considered in parallel with the recommendations from the Hamburger review. In addition to this, as I have already mentioned, there are a number of recommendations that require further government consideration.
Madam Assistant Speaker, the Burnet Institute report looks briefly at the issue of a trial needle and syringe program at the AMC. Recommendation 69 advocates that a process should be commenced to instigate a trial NSP at the AMC. I have previously placed on record my understanding of and support for the underpinning health rationale for such an approach. Indeed, I do support a needle and syringe program at the AMC as health minister. However, I also acknowledge that this is a complex issue that requires a considered response by government before any final decision is made.
Since the report has been received, I have been seeking the views of a range of stakeholders in relation to this matter. However, I believe that further work is required before the government will be in a position to reach a final decision on this important issue. The government will immediately commission a project that will look at further work around a future needle and syringe program. This work will cover potential models for an NSP, how they could work in the prison setting, barriers to implementation at the AMC, and how and if these barriers could be overcome. I have asked Mr Michael Moore, former ACT health minister and currently Chief Executive of the Public Health Association, to lead this work.
The report makes a number of recommendations that are likely to require new and additional resources to implement, including addressing issues such as counselling services and trials of the provision of naloxone to prisoners and, as I have mentioned, the needle and syringe program within the jail. These are all issues that the government will consider carefully in the development of our final government response.
The Burnet report stated that some key informants felt “that prisoners experienced undue influence from health staff to commence methadone”. On my advice, there is no evidence to show that this is occurring. I am advised by ACT Health that methadone is prescribed in the AMC according to the ACT opioid maintenance treatment guidelines. That means the client is assessed for opioid dependence by a medical officer prior to commencing the program. If the person is already on an opioid treatment program they are continued on the program using information from their prescribing doctor and their care is transferred to the AMC doctor. If the person
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