title: Methadone maintenance in prison: evaluation of a pilot program in Puerto Rico.
abstract: OBJECTIVE
  To describe and evaluate a pilot methadone maintenance program for heroin-dependent inmates of Las Malvinas men's prison in San Juan, Puerto Rico.
  
  
  METHODS
  Data from self-report of inmates' drug use before and during incarceration, attitudes about drug treatment in general and methadone maintenance in particular, and expectations about behaviors upon release from prison and from testing inmates' urine were analyzed comparing program patients (n=20) and inmates selected at random from the prison population (n=40). Qualitative data obtained by interviewing program staff, the correctional officers and superintendent, and commonwealth officials responsible for establishing and operating the program were analyzed to identify attitudes about methadone and program effectiveness.
  
  
  RESULTS
  Heroin use among prisoners not in treatment was common; 58% reported any use while incarcerated and 38% reported use in past 30 days. All patients in the treatment program had used heroin in prison in the 30 days prior to enrolling in treatment. While in treatment, the percentage of patients not using heroin was reduced, according to both self-report and urine testing, to one in 18 (94% reduction) and one in 20 (95% reduction), respectively. Participation in treatment was associated with an increased acceptance of methadone maintenance. Prison personnel and commonwealth officials were supportive of the program.
  
  
  CONCLUSIONS
  The program appears to be a success, and prison officials have begun an expansion from the current ceiling of 24 inmates to treat 300 or more inmates.
authors.affiliation: Department of Epidemiology and Public Health, Yale University School of Medicine, P.O. Box 208034, 60 College Street, New Haven, CT 06520-8034, USA. robert.heimer@yale.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Heimer
authors.forename: Holly
authors.initials: H
authors.lastname: Catania
authors.forename: Robert G
authors.initials: RG
authors.lastname: Newman
authors.forename: John
authors.initials: J
authors.lastname: Zambrano
authors.forename: Arlyn
authors.initials: A
authors.lastname: Brunet
authors.forename: Arturo Marti
authors.initials: AM
authors.lastname: Ortiz
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D010865:Pilot Projects; D011329:Prisoners / Q000706:statistics & numerical data; D011330:Prisons; D016730:Program Development; D015397:Program Evaluation; D011613:Psychotherapy; D011647:Puerto Rico
chemical_list: D009294:Narcotics; D008691:Methadone