A Study of Methadone Maintenance for Male Prisoners

Abstract

This study examined benefits of methadone maintenance among prerelease prison inmates. Incarcerated males with preincarceration heroin dependence (n = 197) were randomly assigned to (a) group educational counseling (counseling only); (b) counseling, with opportunity to begin methadone maintenance on release (counseling + transfer); or (c) counseling and methadone maintenance in prison, with opportunity to continue methadone maintenance on release (counseling + methadone). At 90-day follow-up, counseling + methadone participants were significantly more likely than counseling-only and counseling + transfer participants to attend drug treatment (p = . 0001) and less likely to be reincarcerated (p = .019). Counseling + methadone and counseling + transfer participants were significantly less likely (all ps < .05) to report heroin use, cocaine use, and criminal involvement than counseling-only participants. Follow-up is needed to determine whether these findings hold over a longer period. Keywords heroin addiction; prisoners; methadone maintenanceOf the more than 2 million adults incarcerated in the United States (Harrison & Beck, 2005), an estimated 12% to 15% have preincarceration histories of heroin addiction (Chaiken, 2000;Karberg & James, 2005). Longitudinal studies have consistently found that rapid relapse to opioid (principally, heroin) addiction following incarceration is a continuing problem. Several reports indicate that readdiction is typically well established within 90 days of release (Office of National Drug Control Policy, 1999;Stewart, 1995;Wexler, Lipton, & Johnson;1988), whereas other reports have found that most incarceration episodes are followed by relapse as early as 1 month after release (Kinlock, Battjes, & Schwartz, 2002; Maddux & Desmond, 1981;Nurco, Hanlon, & Kinlock, 1991).In addition to its high prevalence, readdiction to heroin is accompanied by increased criminal activity (Chaiken & Chaiken, 1990;Kinlock, O'Grady, & Hanlon, 2003;Nurco, 1998), disproportionately high risk of HIV infection (Chitwood, Comerford, & Weatherby, 1998; Correspondence concerning this article should be addressed to Timothy W. Kinlock Inciardi, McBride, & Surratt, 1998), Hepatitis B and C infections (Edlin, 2002;Fuller, Vlahov, Safeian, Ompad, & Strathdee, 1999;Hagan et al., 2002) (Inciardi et al., 1998;Mark et al., 2001), and impaired parenting (Keller, Catalano, Haggerty, & Fleming, 2002). Thus, the development and implementation of effective drug abuse treatment strategies for incarcerated offenders with heroin-addiction histories is urgently needed, not only for such individuals' rehabilitation but also for their survival and for the safety and welfare of the public (Kinlock et al., 2002;Rich, Boutwell, et al., 2005; SmithRohrberg, Bruce, & Altice, 2004).Furthermore, researchers, practitioners, and policy makers have emphasized that the first 3 months after release to the community is a crucial period for newly released prisoners. If successful reintegration is not achieved during this period, it ...

Naltrexone Implants Compared to Methadone: Outcomes Six Months after Prison Release

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If Drug Treatment Works So Well, Why Are So Many Drug Users in Prison?

“…In several recent papers, Gordon et al (2008) and Kinlock and colleagues examined drug and crime outcomes of 211 heroin-dependent Baltimore prisoners who were randomly assigned to methadone maintenance or a control-group counseling intervention Kinlock et al 2007;Kinlock et al 2008;Kinlock et al 2009). Offenders offered methadone maintenance shortly after release were significantly less likely to use heroin/cocaine or engage in criminal activity compared to those assigned to the control group.…”

Improving Healthcare for Incarcerated Women

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