PRISONERS who are put on forced detox are at greater risk of overdose and death, a leading GP in addiction services has warned.
Dr Cathal O'Sullivan, HSE East Coast GP co-ordinator for addiction services, told Dublin Coroner's Court that detoxing heroin-addicted prisoners was not an "appropriate" form of treatment. The majority would relapse when released and a "huge proportion" of those would die, he said.
"They lose their tolerance for opiates. Then they go out on the streets and take the same amount of opiates or methadone that they had been taking and they die because their body cannot handle it," he said.
He told the court that prison doctors were unable to place prisoners on a methadone maintenance programme unless they were able to ensure its continuation once they were released.
However, waiting lists on methadone programmes around the country could range from two weeks to two years, he said. When places cannot be secured, prisoners were subject to "forcible detox", he said.
"Access to treatment is the real problem here," he said.
Dr O'Sullivan was giving evidence at the inquest into the death of Alan Hempenstall, a 37-year-old homeless man who overdosed on methadone while on temporary release from Wheatfield Prison.
He was found in a laneway behind O'Connell Street on March 28, 2011, with two bottles of methadone prescribed for another man in his vicinity.
A toxicology screen found that Mr Hempenstall had a toxic level of methadone in his system. He died when he went into respiratory failure as a result of methadone toxicity.
The inquest previously heard that Mr Hempenstall had been given full temporary release from Wheatfield Prison on March 9 as a result of prison overcrowding.
He was homeless at the time and an Irish Prison Service (IPS) official admitted that the release had not met "best practice standards".
The jury returned a verdict of death by misadventure. They recommended that the prison service examine the issues surrounding detox raised by Dr O'Sullivan.
They also endorsed more than 20 recommendations submitted by the Irish Human Rights Commission, acting on behalf of Mr Hempenstall's sister Donna O'Connor.
The recommendations included that the IPS establish a means to identify "vulnerable" prisoners and put a structured release programme in place prior to discharge.
Mrs O'Connor said that she hoped something good could come of the inquest.
"Nothing can be done to help Alan but maybe someone else might benefit," she said.