Yale study: Methadone treatment in prison improves inmates' behavior, likelihood of staying clean post-release

Inmates who were given methadone to treat their opioid dependence while in jail were less likely to be disciplined for bad behavior and more apt to continue their treatment after release, according to a state-funded evaluation of data by Yale School of Medicine researchers.

The research, published online in the Journal of Addiction Medicine, revealed that inmates who had consistent methadone treatment before, during, and after incarceration were five times less likely to be re-arrested for a felony and 10 times less likely to be charged with a drug offense after release.

Despite its effectiveness in treatment, methadone is available in fewer than half of U.S. prisons and jails largely due to bureaucratic reasons. Inmates are often forced to discontinue treatment upon incarceration and go through withdrawal. "We don't take away people's insulin or their asthma inhalers when we incarcerate someone. Why should we take away their methadone?" said Dr. Kathleen Maurer, Director of Health and Addiction Services for Connecticut’s correctional system.

Maurer led the effort to develop the methadone program in the New Haven Correctional Center, in partnership with the Connecticut Department of Mental Health and Addiction Services (DMHAS) and the APT Foundation in New Haven.

"When this program started, methadone was completely new to me” said New Haven Correctional Center Warden Joseph Feliciano. “Once I started to see our inmates being treated, I realized that not only was it important from a medical perspective, but it made my job of running the jail easier.”

Our findings highlight that engaging a community provider to dispense methadone in a correctional setting is both feasible and effective.

Sherry McKee, PhD, Professor of Psychiatry at Yale

The study involved 382 inmates at an all-male jail in Connecticut. All inmates received community-based methadone treatment just prior to incarceration, but only half continued treatment while in jail.

The inmates who continued their treatment were about three times less likely to receive disciplinary tickets while incarcerated, according to the research. They were 32 times more likely to visit a community-based methadone provider to continue treatment within one day of release.

By 30 days after their release, 41 percent were continuing their treatment in the community, compared to 10 percent of inmates who did not receive methadone in jail.

The research also revealed that inmates had lower odds of being re-arrested and returning to jail if they continued treatment with the in-jail methadone provider, in this case the APT Foundation.

“Methadone is subject to several levels of regulatory control, creating barriers to providing this evidence-based treatment in prison and jails,” said Sherry McKee, PhD, Professor of Psychiatry at Yale who led the evaluation and was the paper’s senior author. “Our findings highlight that engaging a community provider to dispense methadone in a correctional setting is both feasible and effective.”

"Individuals being released from incarceration with opioid use disorders are at very high risk for overdose or relapse,” said Miriam Delphin-Rittmon, DMHAS Commissioner. “I’m pleased to partner with the Department of Correction and the APT Foundation on this important initiative, as it allows us to provide continuity of care for individuals as they return to their communities."

Kelly Moore, PhD, a Yale School of Medicine postdoctoral fellow, was first author of the paper. Other Yale authors were Lindsay Oberleitner, PhD, and Kathryn Smith, PhD.

This article was submitted by Christopher S Gardner on January 23, 2018.