No Methadone Therapy for US Prisoners

By Dirk Hanson 05/03/11

Riker’s Island offers methadone to addicts, and gets them into community programs after release. Other prisons, not so much.

Waiting for treatment.
Photo via acslaw

Addicts in prison don’t have it easy. They’re thrown into a cold turkey environment, where genuine treatment is haphazard or nonexistent. Thank goodness they can avail themselves of a methadone maintenance treatment program while they are prisoners so that….

No, excuse us, we were thinking of prisons in most European Union nations. We were thinking of the “best practice” recommendations made by the World Health Organization, the U.N. Office on Drugs and Crime, and many other expert international organizations. No matter: U.S. prisons, with a few noteworthy exceptions, don’t allow in-prison methadone programs. The U.S. criminal justice system believes that giving psychoactive drugs—"exchanging one narcotic for another"—to inmates is a bad idea. And it certainly is—except that at the normal dosage and usage patterns, prisoners don’t get anything like a heroin high. This cheap and simple method of treating heroin addicts in prison not only aids addicts seeking to recover, but also cuts down on in-prison heroin smuggling. While it's true that some methadone gets black-marketed in prison, this problem can be solved in part with an alternative treatment—buprenorphine—which doesn’t have to be administered daily, making black market resale more difficult.

Methadone programs are in place at New York City’s Riker’s Island Correctional Facility, and at selected prisons in Baltimore, Philadelphia, Rhode Island, and elsewhere. A National Institute of Drug Abuse (N.I.D.A.) study earlier this year, covered in a previous post, estimated that only one-fifth of the nation’s inmates needing formal treatment are able to get it. Writing in the Atlantic, Jessica Wapner quotes Joanne Csete of Columbia University's Mailman School for Public Health: "In clinical terms, opiate addiction is a chronic disease. [It's not] a weakness of character, where if only they had the personal strength they wouldn't need methadone." Csete compares withholding methadone from imprisoned addicts to refusing to give diabetic prisoners insulin.

In addition to being the medically ethical approach, methadone therapy is also cost effective, argues Wapner, citing study findings that for every dollar apent on methadone treatment that results in a successful recovery, taxpayers spend four dollars for offering no treatment, which results in much higher rates opf crime, disease, and incarceration. “In other words,” she writes, “drug addicts cost the country more than recovering drug addicts.” Prisons seem to be missing a prime opportunity for turning the former into the latter.

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Dirk Hanson, MA, is a freelance science writer and the author of The Chemical Carousel: What Science Tells Us About Beating Addiction. He is also the author of The New Alchemists: Silicon Valley and the Microelectronics Revolution. He has worked as a business and science reporter for numerous magazines and trade publications including Wired, Scientific American, The Dana Foundation and more. He currently edits the Addiction Inbox blog. Email: [email protected]