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Drug Alcohol Depend. 2009 Nov 1;105(1-2):83-8. doi: 10.1016/j.drugalcdep.2009.06.015. Epub 2009 Jul 21.

Methadone and buprenorphine prescribing and referral practices in US prison systems: results from a nationwide survey.

Author information

1
Alpert Medical School of Brown University, Division of Infectious Diseases, 164 Summit Avenue, Providence, RI 02906, USA. amy_nunn@brown.edu

Erratum in

  • Drug Alcohol Depend. 2011 Jan 15;113(2-3):252.

Abstract

BACKGROUND:

More than 50% of incarcerated individuals have a history of substance use, and over 200,000 individuals with heroin addiction pass through American correctional facilities annually. Opiate replacement therapy (ORT) with methadone or buprenorphine is an effective treatment for opiate dependence and can reduce drug-related disease and recidivism for inmates. Provision of ORT is nevertheless a frequently neglected intervention in the correctional setting.

OBJECTIVE AND METHODS:

We surveyed the 50 state; Washington, District of Columbia (DC); and Federal Department of Corrections' medical directors or their equivalents about their facilities' ORT prescribing policies and referral programs for inmates leaving prison.

RESULTS:

We received responses from 51 of 52 prison systems nationwide. Twenty-eight prison systems (55%) offer methadone to inmates in some situations. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Seven states' prison systems (14%) offer buprenorphine to some inmates. The most common reason cited for not offering ORT was that facilities "prefer drug-free detoxification over providing methadone or buprenorphine." Twenty-three states' prison systems (45%) provide referrals for some inmates to methadone maintenance programs after release, which increased from 8% in 2003; 15 states' prison systems (29%) provide some referrals to community buprenorphine providers.

CONCLUSION:

Despite demonstrated social, medical, and economic benefits of providing ORT to inmates during incarceration and linkage to ORT upon release, many prison systems nationwide still do not offer pharmacological treatment for opiate addiction or referrals for ORT upon release.

PMID:
19625142
PMCID:
PMC2743749
DOI:
10.1016/j.drugalcdep.2009.06.015
[Indexed for MEDLINE]
Free PMC Article

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