Inmates cut off methadone less likely to seek it after release
published on March 28, 2015 by David Orenstein in Brown University
When people on methadone maintenance treatment (MMT) are incarcerated in the United States, they are almost always forced off of the addiction-controlling medicine. In a randomized trial led by researchers at Brown University and The Miriam Hospital, inmates allowed to stay on MMT while in jail proved much more likely to seek treatment after release than those whose treatment was interrupted.
PROVIDENCE, R.I. [Brown University] – New trial results published in The Lancet show that inmates forced off of methadone maintenance treatment upon incarceration – a widespread policy in U.S. prisons and jails – were significantly less likely to return to the effective addiction-controlling remedy after they were released than those who, because of the study, were allowed to remain in treatment.
Correction policy correction?
Rich said the study results have already had an impact in Rhode Island, where prison officials recently decided to lengthen the period of time before phasing out MMT from one week after incarceration to six weeks.
Some public health experts are calling for more.
“[The study] provides another example of how the demands of public security can unwittingly undermine public health,” wrote M-J Milloy of St. Paul’s Hospital in Vancouver and Dr. Evan Wood of the University of British Columbia in an accompanying editorial in The Lancet. “To not only improve the health of those dependent on opioids but also honor the international legal obligation for equivalence of correctional and community-based healthcare, correctional systems in the United States and other jurisdictions should move to provide in-prison evidence-based treatment for opioid dependence.”
Rich agreed that the criminal justice practice of cutting people off from MMT runs counter to the public health goal of fighting addiction. In previous work he has shown that many people avoid ever engaging in MMT because they worry that they will be cut off from it if they are arrested. Cold-turkey withdrawal from heroin is intensely horrible for about a week, Rich said, but withdrawal from methadone can mean months of discomfort including lost sleep. Many people see heroin withdrawal as the preferable way to suffer because it is over more quickly.View the full article