A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release. Gordon MS, Kinlock TW, Schwartz RP, O'Grady KE. Addiction 2008 103;8:1333-1342
Dear Colleagues,
These researchers found, predictably, that offering methadone maintenance treatment (MMT) to released prisoners with a history of opiate addiction was feasible, safe and effective, just like it is in the community generally when done according to established guidelines. They compared counselling with/without MMT, finding less heroin use and less criminal activity at 6 months after release in those offered MMT. Treatment retention was also higher.
This is yet another example of American clinical practice which is decades behind other countries. And this is despite heroin addiction has been accepted as a �brain disease� by the White House and methadone/agonist treatments are now approved in every state. However, for those in the US prison system these maxims do not apply for some reason. Note that this study was not published in an American journal.
Almost uniquely, in New South Wales, prisoners have had access to methadone treatment for over 20 years. It was initially introduced in the 1980s as a pre-release measure to address the high rate of overdoses in that group. There is now a copious world literature on the subject, largely very positive. Methadone for prisoners has now been introduced in many other jurisdictions, although rarely �across the board� as occurs in New South Wales.
Thus a trial which gave some subjects no access to such treatment would be unethical, unnecessary and cruel in a �normal� jurisdiction. Yet in America, despite a large drug budget and constitutional protections, denying prisoners appropriate treatment seems to be �business as usual�. These researchers should be commended for trying to buck the trend. They write that there is an �urgent treatment need� and one only hopes that something is done for the sake of the prisoners, their families and the general community where the adverse consequences currently must be enormous.
Comments by Andrew Byrne ..
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