Work

Why prisons in Slovakia lack opioid agonist treatment: literature review and expert interviews

Year: 2026

Type: article

Abstract: Background Opioid agonist treatment (OAT) is a harm reduction intervention found to decrease the severity of withdrawal symptoms, overdose death, and rate of infectious diseases. Slovakia remains the only country in the European Union (EU) without officially available OAT in prisons, despite its implementation in the community and the evidence of need for opioid use treatment. This study examined the reasons for this gap by investigating the perception of OAT, and the barriers and facilitators of introducing in-prison OAT in Slovakia. Methods Using Zinberg’s model as a theoretical framework, content analysis of qualitative data from three sources was performed. A scoping review of scientific literature as well as of digital/print media on OAT and drug use in Slovak prisons was conducted via PubMed, JSTOR, Central Library of the Slovak Academy of Sciences, and LexisNexis. Findings from this review informed semi-structured interviews with six experts from drug research, the Slovak Ministries of Healthcare and Justice, academia, non-governmental organizations (NGO) and prison psychiatry. Results While the literature review of 23 records (9 scientific and 14 journalistic) was mostly supportive of OAT, it lacked in-depth discussion. Interviews indicated low endorsement from the Ministry of Justice and prison psychiatrists, who deemed it unnecessary due to insufficient evidence on drug use in Slovak prisons, and low awareness thereof. Major barriers included political unwillingness, perceptions of irrelevancy and redundancy, lack of research, poor intersectoral collaboration, and limited resources. Potential facilitators included improved resource allocation, increased awareness, and the involvement of NGO and EU. Conclusions Increased knowledge of available evidence, strong intersectoral cooperation within the government and with NGO, and rigorous data collection are necessary to effectively provide harm reduction programmes such as OAT to the people most in need. Key messages • The study identified existing barriers for the lack of opioid agonist treatment in Slovak prisons, and facilitators able to stimulate the implementation process to ensure equal access to healthcare. • Political unwillingness rooting from the perceived irrelevancy of the treatment could be shifted by more rigorous data collection on in-prison drug use and stronger intersectoral collaboration.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckag169.1911

Authors: R Bódi, L Montanari, PHHM Lemmens

Institution: Maastricht University

Language: English

Topic: Opioid Use Disorder Treatment

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $3,181