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Scaling up access to NSPs and MMT in prisons in Moldova: successes and challenges Vienna, 22 July 2010 Ralf Jürgens, consultant. Acknowledgements. J Hoover, V Vovc, L Pintilei, V Toncoglaz Department of Penitentiary Institutions, Moldova Ministry of Justice
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Scaling up access to NSPs and MMT in prisons in Moldova: successes and challenges Vienna, 22 July 2010 Ralf Jürgens, consultant
Acknowledgements J Hoover, V Vovc, L Pintilei, V Toncoglaz Department of Penitentiary Institutions, Moldova Ministry of Justice NGO “Innovative Projects in Prisons” Soros Foundation – Moldova Intl Harm Reduction Development Program, OSI
Methodology • review of the literature • Site visits in August 2007 & October 2008 • 7 prisons & 1 pretrial detention facility • headquarters of penitentiary system, NGO, Soros Foundation • Interviews with prisoners, pre-trial detainees, NGO staff, penitentiary system officials & employees, Foundation staff • peer review
Needle & syringe programs NSPs in the community exist in most countries and have been proven to be effective In prisons, they were first established in Switzerland in 1992 Several models for distribution: health care, automatic dispensing machines, peer outreach workers Moldova’s model represents international best practice 4
Methadone maintenance treatment (MMT) • MMT successfully introduced in some prisons in Moldova • eligibility criteria have been revised – initially they were too restrictive • possibility to continue methadone treatment beyond 6 months was introduced – this is crucial to achieve good results • number of prisoners on MMT growing
Methadone maintenance treatment • Good results documented for prison administration and for prisoners • “Many problems have decreased for us. Prisoners on methadone are doing much better and they are much more disciplined.” • My mother, my brothers and sisters are all very happy, and I know I will be able to help them when I will be released, rather than being a burden all the time.” • Risk of diversion successfully addressed
Challenges for other countries learn from Moldovan model: leadership & pragmatism of penitentiary department, combined with trainings & providing legal basis involvement of NGO adoption of peer model provision of comprehensive harm reduction program & methadone treatment addressing broader issues of overcrowding, prison conditions, activities for prisoners, staff conditions move from evidence to action 7