A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release.
OBJECTIVE
This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release.


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


METHODS
A Baltimore pre-release prison.


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


METHODS
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).


METHODS
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.


RESULTS
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.
Gordon
Michael S
MS
Friends Research Institute, Baltimore, MD 21201, USA. mgordon@friendssocialresearch.org
Kinlock
Timothy W
TW
Schwartz
Robert P
RP
O'Grady
Kevin E
KE
D000328:Adult; D015142:Baltimore; D003376:Counseling / Q000379:methods*; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011329:Prisoners / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers
D009294:Narcotics; D008691:Methadone