Page 3836 - Week 10 - Thursday, 14 September 2017
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2. The Justice Health Services Opioid Replacement Procedure stipulates that all opioid replacement treatment including Suboxone, are to be supervised by nursing staff. The administration of suboxone occurs within the Hume Health Centre and is supervised. The supervision of the administration of the suboxone includes:
• Checking the detainee’s mouth to confirm there are no foreign bodies in the mouth, and dentures are to be removed;
• Nurses look inside the detainee’s mouth every 30 seconds to check for absorption (Suboxone is absorbed sublingually within 2-7 minutes) and decrease the likelihood of diversion of the dose; and
• The detainee will remain under supervision until the film has dissolved and are instructed to drink a cup of water after the film has fully dissolved.
Prior to a person commencing on opioid treatment they must sign a treatment agreement, which indicates the person’s consent to the treatment and their commitment to abide by the rules of the program. If a patient breaks the agreement and is found to be diverting their medication, the patient is counseled by senior JHS clinicians who attempt to ascertain the reasons for the diversion. Where diversion is suspected for a second time, discussion occurs with the Clinical Director and a decision is made about the person’s place on the program.
3. In November 2016, a review of the process of the Justice Health Service’s opiate treatment program commenced. In July 2017, the revised Clinical Procedure for Justice Health Service’s opiate treatment program was endorsed and has been implemented. The changes include:
• Establishing a one day delay in commencing a detainee on methadone /suboxone following induction into the program, so that clinical issues can be appropriately identified, assessed and managed;
• Establishing a 2:00pm daily deadline for methadone /suboxone to be administered, so that Justice Health Services staff are available on site during the most common peak time of methadone /suboxone effect;
• Formalising the observation process undertaken by nursing staff before, during and after dosing, generally for all detainees and specifically for detainees in the first six days of commencing ORT; and
• Formal notification to ACT Corrective Services when a detainee is commenced on ORT (this information is shared with the consent of the detainee).
As of 8 August 2017, there are 4 detainees on suboxone.
Bimberi Youth Justice Centre—Human Rights Commission referral
Ms Stephen-Smith (in reply to a supplementary question by Mrs Kikkert on Wednesday, 16 August 2017):
1. The matters the Human Rights Commission chooses to investigate are an issue for the Human Rights Commission.
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