Citation

Gordon MS, Kinlock TW, Schwartz RP, O'Grady KE. Addiction 2008; 103(8): 1333-1342.

Copyright

(Copyright © 2008, John Wiley and Sons)

DOI

10.1111/j.1360-0443.2008.002238.x

PMID

unavailable

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.