The Effectiveness of In-Jail Methadone Maintenance

Abstract

Process and outcome evaluation results are reported for a unique in-jail methadone maintenance program in New York City with three thousand admissions annually. The main study examined inmates who were not enrolled in methadone at arrest. Eighty percent were drug injectors (usually both heroin and cocaine) who admitted committing an average of 117 property crimes and nineteen violent crimes in the six months before jail. Methadone program participants' post-release outcomes were compared with outcomes for similar addicts who received seven-day heroin detoxification in jail. Multivariate analyses indicated that program participants were more likely than controls to apply for methadone or other drug abuse treatment after release and to be in treatment at a 6.5-month follow-up. Moreover, being in treatment at follow-up was associated with lower drug use and crime, but rates of retention in community treatment after release were modest. KEEP participants have more chronic and severe social and personal deficits than other addicts applying for treatment. The in-jail program was most effective in maintaining post-release continuity of methadone treatment for inmates already enrolled in methadone at arrest. The process evaluation yielded several recommendations to help overcome client-centered, administrative, and systemic obstacles to improved outcomes for this difficult-to-treat population of criminally-involved addicts.

Methadone maintenance treatment program in prisons from the perspective of medical and non-medical prison staff: a qualitative study in Iran

“…In other words, to understand methadone therapy completely, common objectives of withdrawal programs must be also taken into account: 1) Eliminating or reducing withdrawal symptoms, 2) Eliminating or reducing the craving for drugs, 3) Preventing recurrence of addiction, 4) Restoring the physiological activity level which has been lost due to drug abuse, and 5) Reducing criminal behaviors and improving behaviors that affect social and psychological health (27,(41)(42)(43). Iran is considered as one of the most successful countries in the field of methadone therapy as a method of harm reduction (44), however, various studies conducted in other countries have also shown the success of methadone therapy in harm reduction, especially in reducing high-risk behaviors such as shared injection (15,19,28,41,45,46). Thus, according to the results of the present research, the weaknesses extracted from these programs can be a guide to review and continue MMT programs in Iran prisons.…”

Does incarceration-based drug treatment reduce recidivism? A meta-analytic synthesis of the research

“…The outlier came from an evaluation of a narcotics maintenance program(Magura et al 1993, female sample). The logged odds ratio for this contrast was -4.61, indicating that the comparison group had a lower rate of post-release offending than the treatment group did.…”

New South Wales Corrections Health Service: harm minimisation within a correctional centre — How do we rate?

“…Methadone programs: In 1986, two correctional centre-based methadone programs began; one in NSW Australia (Hall et al, 1993) and the other in Rikers Island, New York (Magura et al, 1993). The Australian program began as pre-release one with the aim of preventing re-incarceration (Hall et al, 1993).…”