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A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release

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Abstract:

ABSTRACT Aims 

This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release. Design 

A three-group randomized controlled trial was conducted between September 2003 and June 2005. Setting 

A Baltimore pre-release prison. Participants 

Two hundred and eleven adult pre-release inmates who were heroin-dependent during the year prior to incarceration. Intervention 

Participants were assigned randomly to the following: counseling only: counseling in prison, with passive referral to treatment upon release (n = 70); counseling + transfer: counseling in prison with transfer to methadone maintenance treatment upon release (n = 70); and counseling + methadone: methadone maintenance and counseling in prison, continued in a community-based methadone maintenance program upon release (n = 71). Measurements 

Addiction Severity Index at study entry and follow-up. Additional assessments at 6 months post-release were treatment record review; urine drug testing for opioids, cocaine and other illicit drugs. Findings 

Counseling + methadone participants were significantly more likely than both counseling only and counseling + transfer participants to be retained in drug abuse treatment (P = 0.0001) and significantly less likely to have an opioid-positive urine specimen compared to counseling only (P = 0.002). Furthermore, counseling + methadone participants reported significantly fewer days of involvement in self-reported heroin use and criminal activity than counseling only participants. Conclusions 

Methadone maintenance, initiated prior to or immediately after release from prison, increases treatment entry and reduces heroin use at 6 months post-release compared to counseling only. This intervention may be able to fill an urgent treatment need for prisoners with heroin addiction histories.

Keywords: Heroin addiction; methadone maintenance; prisoners; randomized clinical trial; substance abuse treatment

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1360-0443.2008.002238.x

Affiliations: Department of Psychology, University of Maryland, College Park, MD, USA

Publication date: August 1, 2008

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