needed for intimate body checks, it should be a public health ofcer or a physician not involved in the care of prisoners. Drug‑free prison departments Several countries have established drug‑free zones or departments in prisons, where prisoners consent to frequent random urine tests proving them to be drug‑free in return for incentives with privileges and/or better living conditions compared to regular prison departments. Inmates showing posi‑ tive in drug tests are immediately sent back to a regular prison department. This combination of stimulating motivation with monitoring control has proved successful in preventing demand and supply of drugs, strengthening prisoners’ autonomy, reducing confict and improving the working conditions for staf. This is suitable only for prisoners who have a high motivation not to get in contact with drugs while serving their prison sentence.11 Substitution treatment programmes Oral opioid‑maintenance substitution is not only the most effective and best documented treatment for opiate dependency, and thus regarded as state‑of‑the‑art treatment for opiate‑injecting drug users, but is also as one of the most powerful preventive measures against the spread of HIV/ Aids and hepatitis B and C. It reduces the demand for risky intravenous consumption of opiates, stabilises the patients so that they can undergo additional psychotherapeutic treatment and helps to retain them in psy‑ chosocial treatment.12 In line with the principle of equivalence of care, which applies not only to therapeutic but also to preventive health care,13 in all countries where opiate‑substitution programmes are implemented in the community, they should also be available in prison. This is essential not only for ethical reasons but also for clear clinical and preventive reasons: interruption of opiate sub‑ stitution leads to an opiate‑withdrawal syndrome in the vulnerable phase of imprisonment and increases the risk that intravenous drug use is resumed. As a rule, viral transmission is much more risky in the prison environment than 11. EMCDDA: Best practice portal: Drug free zone in Hirtenberg prison (2001) at www.emcdda. europa.eu/html.cfm/index52035EN.html?project_id=57&tab=overview. 12. WHO/UNODC/UNAIDS: “Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention”, position paper (2004). 13. The CPT Standards 2002 (rev. 2011). Prison health care and medical ethics Page 56