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 ...