Correctional institutions detention shall be provided with the same medical products as persons living in freedom. In particular, detained persons should not be precluded from receiving remedies that have less severe side effects. The NPM recommended making different substitution compounds available in prisons (at a lower cost). The Federal Ministry of Constitutional Affairs, Reforms, Deregulation and Justice argued that the change to methadone has proved to be successful based on the many decisions taken by medical specialists. The NPM cannot follow this stance unconditionally; rather it demands carefully weighing up which medication is best suited in the individual case prior to changing medication. The fact that some of the persons to receive substitution therapy regrettably (are likely to) abuse some medications shall not be used as an excuse not to prescribe and administer the same. Careful change of medication During the visits to St. Pölten correctional institution in November 2018 and January 2019, prison guards claimed that only those detainees who had been on a substitution programme before the detention had commenced receive an opioid substitution therapy. St. Pölten correctional institution The NPM already emphasised last year after a visit to Feldkirch correctional institution that there is an indication for a substitution therapy not only when the patient is already on non-hospitalised substitution upon arrival at the correctional institution. In fact, opioid addiction alone suffices as a basis to be indicated for substitution therapy (see NPM Report 2018, p. 108). It is indisputable that patients who are addicted to opioids must have access to adequate (substitution) therapy. Failure to do so constitutes a violation of Article 3 of the European Convention on Human Rights (ECHR 1.9.2016, Bsw. 62303/13, Wolfgang Adam Wenner versus the Federal Republic of Germany). On the positive side, since July 2018 inmates in Vienna-Josefstadt correctional institution who are taking part in opioid substitution therapy and are due to receive benefits from the Public Employment Service Austria after their release are allowed to temporarily leave the prison two to three weeks before release to register with the Public Employment Service Austria. Access to health insurance benefits (incl. substitution therapy) is thus guaranteed from the day of release. XX Good transition management  A comprehensive risk assessment as to which medication is the most suited in the individual case should always be carried out before substitution medication is changed. Addiction screening and multi-professional treatment team In Klagenfurt correctional institution, the NPM encountered a detainee who was suffering from severe withdrawal. A look at the documentation and consultation with the officers revealed that the inmate had been admitted to the institution four days previously but had not seen a doctor. To ease the Klagenfurt correctional institution 118

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