Zusammenfassung Hintergrund Trotz genereller Fortschritte bei der Hepatitis-C-Behandlung in Deutschland ist unklar, inwieweit dies auch für bestimmte Schlüsselgruppen, wie etwa Inhaftierte, gilt. Methoden In einer Kurzbefragung im Juni 2021 wurden die Justizministerien der Bundesländer über Datenerhebungs- und Diagnostikmethoden sowie die Prävalenz von Infektionen mit dem Hepatitis-C-Virus (HCV) und HCV-Behandlungen von Gefangenen in Deutschland befragt. Ergänzend dazu wurden Expert*inneninterviews zu Barrieren und bisher nicht genutzten Chancen der HCV-Behandlung in Haft geführt. Ergebnisse Es zeigt sich, dass keine vollständige und flächendeckende Datenerhebung innerhalb der Justizministerien vorliegt. Präventionsmaßnahmen wie Opiatsubstitutionstherapie in Haft sind in allen teilnehmenden Bundesländern verfügbar. Spezifischere Angebote und Maßnahmen (z. B. Rasierer, Spritzentausch) finden sich nur vereinzelt und sind teilweise kostenpflichtig. Die Expert*innen zeigen auf, dass die Behandlung innerhalb der Justizvollzugsanstalten zwar grundsätzlich dem Äquivalenzprinzip nachkommt, aber die Zielgruppe schwerer zu erreichen ist. Fazit Wichtig für eine erfolgreiche HCV-Eliminierung in Justizvollzugsanstalten sind eine flächendeckende Aufklärung und Beratung zur HCV-Behandlung, konsequente HCV-Testung und -Behandlung sowie Präventionsmaßnahmen zur Vermeidung von (Re)Infektionen.

Social work in prisons is linked to specific tasks regarding the care for the people who are incarcerated. A multi-country qualitative study was set up to explore drug users’ and professionals’ perceptions of continuity of care in prison and beyond. It has been pointed out that continuity of care is associated with different barriers, especially regarding social work. Nevertheless, good practice examples do exist and could be implemented by social workers. Social workers and opioid users face challenges in the context of imprisonment, so different measures need to be implemented to support opioid users and for social workers to support them.

BACKGROUND:Despite general advances in the treatment of people with hepatitis C in Germany, it is unclear to what extent this also applies to specific key populations, such as prisoners. METHODS:In a short survey conducted in June 2021, the ministries of justice in the federal states were asked about data collection and diagnostic methods as well as the prevalence of infections caused by the hepatitis C virus (HCV) and HCV treatment among prisoners in Germany. In addition, expert interviews were conducted regarding HCV treatment barriers and missed opportunities in prisons. RESULTS:It is evident that there is no complete and comprehensive data collection within the ministries of justice. Prevention measures, such as opiate substitution therapy in prison, are available in all participating federal states. More specific offers and measures (e.g., razor and syringe exchange) are only found in a few cases and are sometimes subject to a charge. Experts point out that although treatment in prison generally complies with the equivalence principle: it is more difficult to reach the target group. CONCLUSIONS:Comprehensive education and counselling on HCV treatment, consistent HCV testing and treatment, and preventive measures to avoid (re-)infection are important for successful HCV elimination in prisons.

INTRODUCTION:Improving the knowledge and attitudes of people facing an opioid overdose is one of the key prevention measures for reducing overdose occurrence and severity. In this respect, the Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS) have been developed and validated in English to assess and improve knowledge and attitudes of opioid users and their families and care providers, in case of an overdose. Here, the OOKS and OOAS scales have been translated into French, Spanish, and German, and the different versions of the 2 scales have been assessed regarding their psychometric properties.METHODS:The translation procedure of the scales was based on the international recommendations, including a back translation by a native English speaker. Subsequently, 80 (Spain: 29, France: 27, Germany: 24) former or current heroin users, aged from 20 to 61 years (M = 39.4 ± 9.23), completed the OOKS and OOAS versions of their native language, in test-retest, without specific between-assessment training. Internal consistency was assessed using Cronbach's α, while test-retest reliability was assessed using intraclass correlation coefficient (ICC). The correlation between the OOKS and OOAS scores of a same language was assessed using Spearman's (ρ) coefficient.RESULTS:Internal consistency of the OOKS was found to be good to very good, with Cronbach's α ranging from 0.62 to 0.87. Test-retest reliability was also very good, with ICCs ranging from 0.71 to 0.82. However, results were less reliable for the OOAS, as internal consistency was questionable to acceptable, with Cronbach's α ranging from 0.12 to 0.63, while test-retest ICCs were very good for the French (0.91) and Spanish (0.99) versions and barely acceptable for the German version (0.41). No significant correlation was found between the OOKS and OOAS scores, irrespective of the version concerned.CONCLUSION:While satisfactory results were found for the 3 versions of the OOKS, results on the OOAS were relatively inconsistent, suggesting a possible gap between knowledge and attitudes on overdose among opioid users.

Background Prisoners report much higher prevalence rates of drug use and more harmful consumption patterns than the general population. People who use drugs have above-average experiences with the criminal justice system in general, and the prison system and subsequent release situations in particular. Release from prison is associated with increased mortality rates among drug users due to the risk of overdose. The EU-funded project ‘My first 48 hours out’ aimed to address the gaps in continuity of care for long-term drug users in prison and upon release, with a special focus on drug user’s perspectives on needs and challenges upon release. Methods A multi-country (Belgium, France, Germany and Portugal) qualitative study was set up to explore drug users’ perceptions of drug use and risk behaviour upon prison release, experiences of incarceration and release, and strategies to avoid risks when being released. In total, 104 prisoners and recently released persons with a history of drug use participated in semi-structured interviews and focus groups discussions on these topics. Results Respondents pointed out that there are numerous challenges for people who use drugs when released from prison. Lack of stable housing and employment support were frequently mentioned, as well as complex administrative procedures regarding access to services, health insurance and welfare benefits. Besides structural challenges, individual issues may challenge social reintegration like ‘old habits’, mental health problems and disrupted social networks. As a result, (ex-)prisoners adopt individual strategies to cope with the risks and challenges at release. Conclusion Measures to prepare prisoners for release often do not focus on the individual and specific challenges of persons who use drugs. Psychosocial and medical support need to be improved and adjusted to drug users’ needs inside and outside prison. To improve the quality and continuity of care around release, the perspectives and coping strategies of people who use drugs should be used to better address their needs and barriers to treatment.

Zusammen mit marginalisierten Drogenkonsument_innen aus Frankfurt und Berlin wurden insgesamt 3 partizipative Kartierungsworkshops durchgefuhrt. Dabei haben die Teilneh-mer_innen Vorschlage fur eine Stadt(planung) der idealen Stadt erarbeitet, in welcher ihre Lebensumstande, alltaglichen Herausforderungen und Existenz im offentlichen Raum berucksichtig und toleriert werden.

Zusammenfassung In Gefängnissen sind Personen, die Drogen gebrauchen, im Vergleich zur Allgemeinbevölkerung überdurchschnittlich häufig vertreten. Der Konsum illegaler Substanzen, insbesondere von Opioiden, geht insbesondere im Setting Haft mit hohen physischen und psychischen Gesundheitsrisiken einher. Der Beitrag gibt einen Überblick über die Konsumprävalenzen, existierende Maßnahmen im Strafvollzug sowie mögliche Maßnahmen zur Schadensminimierung in Haft und bei Haftentlassung.

Einleitung Drogenkonsumräume (DKR) haben seit ihrer Einführung vor über 20 Jahren nachgewiesenermaßen große Veränderungen in der Versorgung von drogenkonsumierenden Menschen bewirkt. Aus der Perspektive von Konsumierenden der offenen Szene, insbesondere im Kontext der Bedeutung der DKR für den alltäglichen gelebten Raum der Konsumierenden selbst, wurden diese bislang jedoch wenig untersucht.

Background The above-average proportion of people with opioid use disorder living in prisons is a worldwide reality, and the need to treat these people was recognized internationally more than 20 years ago. Studies have shown that substitution therapies are best suited to treat opioid use disorder and reduce the risk of HIV and hepatitis C transmission and overdose. However, huge health inequalities exist in and outside of prison due to the different implementation of opioid substitution therapy (OST). People living in prisons are entitled to the best possible health care. This is established by the Universal Declaration of Human Rights and by the International Convention on Economic, Social and Cultural Rights. Solely the imprisonment, and not the loss of fundamental human rights, constitutes the punishment. Methods A qualitative literature search using PubMed and Google Scholar was performed in order to identify relevant publications. Results This review shows the inequality in availability of opioid substitution therapy for people living in prison compared with people outside of prison in Germany. It also gives possible reasons and evidence for this inequality, showing that continuing or initiating OST in prison is more beneficial for the health of people living in prison than abstinence-oriented treatment only. Conclusion It is important that drug use disorder is treated as a serious illness also in prison. Joint efforts are needed to provide people living in prison with the best possible treatment and to minimize the adverse effects of drug use. Therefore, with laws, policies, and programs that conform to international human rights standards, each state must ensure that people living in prison receive the same health care as people outside of prison.