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Policy gaps: Methadone maintenance treatment in prison

As of today no one knows how prisoners would be treated with methadone after their arrests.

Mr. Ream (fictitious name), a former KHANA outreach worker, was arrested and has been held in prison for 20 days as of today without methadone. His pre-trial detention might put him up to six months or more without methadone treatment.

Mr. Ream has been under methadone treatment at the Cambodian-Russian Friendship Hospital. Mr. Ream can be one example, reflecting lacks of serious debates on how methadone treatment would be made accessible and available at the place where patients could not afford their free movement such as imprisonment.

“Methadone could not be brought to the prison clinic as there is no guidelines or standards of package,” said an official working on harm reduction, asked not to be named. “The prison clinic and the Cambodia-Russia Referral Hospital along with other concerned stakeholders should meet and discuss guidelines that illustrate accountability of the prison clinic and the Cambodia-Russia Referral Hospital,” he added.

When asking how Mr. Ream would continue his methadone treatment, it is clear that methadone could not be brought to him at the prison, and when asks how Mr. Ream could come to get his methadone at the hospital, it seems that there is no answer. The prison is obliged to bring prisoner-patients to the hospital, or to have patients be treated at the prison clinic.

When could Mr. Ream come to get his methadone treatment? How? The case of Mr. Ream could reflect several others who inject drug, but their health is ignored by policy.

There are no policies and procedures to set up methadone maintenance treatment with the prison clinic at the prison, or there are gaps of policies and procedures on how methadone would be made accessible and available at the prison clinic for people under methadone treatment.

“If a patient misses his methadone treatment for several days, his/her health would become worse. His relapse may include overdose,” said a doctor.

Missing methadone treatment may cause different problems for a patient. “Usually it cause vomiting, bad pain on the backbone, running noses, anxiety, diarrhea, etc.,” said a harm reduction official. 

Methadone policy should be seriously discussed and patients in the prison should be identified as the most of all the most patients, for their free movement is suspended.

By Sovannara Mey

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