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Overcoming obstacles to implementing methadone maintenance therapy for prisoners: Implications for policy and practice

Michelle McKenzie, MPH, Amy Nunn, MS, ScD, Nickolas D. Zaller, PhD, Alexander R. Bazazi, BA, Josiah D. Rich, MD, MPH


More than 2.4 million people are currently incarcerated in the United States, many as a result of drugrelated offenses. In addition, more than 200,000 active heroin addicts pass through the correctional system annually. New evidence suggests that both providing prisoners with referrals for community-based methadone programs and providing methadone prior to release reduces recidivism and adverse health and social consequences associated with drug use. This article reports the programmatic challenges associated with initiating methadone treatment in the Rhode Island correctional system. Significant obstacles to implementing methadone treatment include: stigma associated with pharmacological treatment, misconceptions regarding the nature of opioid addiction, logistics of control and storage of methadone, increased work load for nursing staff, and general safety and control concerns. The authors discuss strategies to address these barriers and conclude that providing methadone prior to inmate release is a feasible intervention with the potential to mitigate drugrelated health and social harms.


methadone, incarceration, prisoner health, opiate replacement therapy

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