Study finds test to assist prisoners could provide health system relief

A study led by The University of Western Australia has found a simple screening test to identify at-risk prisoners could reduce hospitalizations related to substance use, providing relief for a health system already under strain.

The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) had already proven effective in identifying people most at risk of relapsing to drug use after leaving the prison system.

Lead author Craig Cumming, a research fellow with UWA's School of Population and Global Health, said this study, published in the journal Addiction, was the first to investigate whether the tool could also be used to predict hospitalizations related to substance abuse after release from prison.

"A range of preventable poor health outcomes after release from prison, including fatal and non-fatal overdose, results in increased emergency department contact and hospitalization that comes at a substantial economic cost," Mr. Cumming said.

"Identifying people at greatest risk of harm would help to target, treat and support those most in need."

The study included more than 2,500 people from prisons in the Queensland and Western Australia, which manages 39% of the nation's prisoner population and 47% of the Indigenous prisoner population.

The study focused on the use of methamphetamine, opioids and cannabis.

Of the participants, 29% had at least one hospitalization related to substance use during the follow-up period, adding up to 2,226 hospitalizations—with methamphetamine accounting for the highest number (520) among the three substances.

Mr. Cumming said the period of high risk could persist for up to several years after release from prison—something the cost-effective ASSIST tool could effectively combat if utilized in prisons.

"There is a strong case for ASSIST to become standard in all prisons, to help identify individuals early in their prison sentence and intervene to prevent their return to harmful substance use," he said.

"But more treatments and supports are also urgently needed in this space."