Registered mail

We write in reply to a letter written by Revel Barker from Għajnsielem and titled ‘Why bother with registered mail?’  (July 1).

While Barker questions the need for a registered mail service he prefers not to mention in his letter that he resides in a building where four out of the six apartments do not have a doorbell at the entrance to the building.

He also prefers not to mention that neither of the only two doorbells at the entrance indicate they pertain to himself or his apartment number.  In fact, the only two doorbells do not even bear a visible apartment number.

The delivery of registered letters in a block of apartments may only be successfully concluded where the buildings bear the correct door number, they are placed in a visible location and also have functioning doorbells with respective apartment number at the entrance of the building.

André Barbara, head, customer care, Maltapost plc – Marsa

Prisoners and drug rehabilitation

I refer to the article ‘Prisoner who died by suicide wanted drug rehab’ (July 7).

May I suggest that the prison authorities urgently refer to a recent publication, Prison and drugs in Europe – Current and future challenges (European Monitoring Centre for Drugs and Drug Addiction 2021, Publications Office of the European Union, Luxembourg). This publication will surprise the prison authorities as to how further they need to bring about change if they want to achieve European standards in the level of care of prison inmates.

They should realise that “the majority of people in prison come from vulnerable population groups and, so, the mere provision of health services equivalent to those available to the general population is unlikely to lead to the same health status. It may therefore be necessary to implement additional and targeted interventions for people in prison in order to achieve equivalence of health outcomes.”

Only last March, Chris Cremona, the surgeon who heads a newly-inaugurated medical centre at Corradino Correctional Facility, was very upbeat about the fact that “the amount of methadone given to drug-addicted prison inmates has decreased by two- thirds in recent months, in an attempt to weed out drug dependency behind bars”.

Further he states that  “there has been an overall effort to reduce drug dependency in the facility and it is now bearing fruit. This doesn’t happen by accident but is part of a coordinated strategy”. 

Cremona should take note of the much-respected opinion of the Independent Expert Working Group in the UK, which, in 2017, recommended clinical guidelines on drug misuse and dependence. It was very clear in its opinion that:

• coerced detoxification from opioid-assisted therapy,  the like of methadone, is likely to lead to relapse to drug use and increased risks of harm such as overdose and blood-borne viruses,

• evidence does not support coercing or encouraging patients to start a gradual reduction of their methadone medication,

• numbers of patients taken off opioid-assisted therapy,  the like of methadone, should not be a measure of the effectiveness of the service.

Cremona should be aware of the abundant literature indicating that when people are taken off opioid-assisted therapy (methadone) they are exposed to increased risk of harm and death. These interventions should only be considered after a collaborative decision between the clinician and the individual.

Such high-risk interventions should only be considered when a safe environment can be guaranteed and the best possible psychosocial support can be afforded.

I am sure that no prison is the best place for such interventions to be considered.

Moses Camilleri, Certified by the International Society of Addiction Medicine – Żebbuġ

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