Most jails and prisons do not provide medication-assisted treatment for opioid addiction. Experts tell NPR that for inmates who are forced to detox from methadone, tolerance for opioids decreases, while cravings increase. This raises their risk of overdose after they are released.
The World Health Organization recommends continued methadone treatment for people who are incarcerated. In the United States, pregnant women are the only inmates likely to be allowed continued treatment with methadone or buprenorphine. Withdrawal from opioids can cause miscarriage, the article notes.
One study found patients who stop methadone treatment are eight to nine times more likely to die soon afterwards, compared with those who do not stop treatment.
Research suggests inmates who receive methadone behind bars are eight times more likely to seek treatment and abstain from drug use in the month following their release, compared with inmates who receive only counseling.
Corrections administrators say they prefer abstinence-based programs because they are concerned inmates can retain methadone in their mouths, even in liquid form, which can then be sold and abused. Facilities would have to become licensed to administer methadone, or would have to transport inmates to methadone clinics, which they often do for pregnant inmates.
Dr. Heidi Ginter, Assistant Chief Medical Officer for Community Substance Abuse Centers, a chain of treatment centers in New England, said her clients who are forced to undergo methadone detox while incarcerated often choose heroin over treatment when they are released.
“This is a human rights issue,” Ginter said. “If somebody with diabetes eats a piece of cake at a birthday party, they don’t get incarcerated. And their doctor doesn’t say, ‘Now I’m not going to prescribe your insulin because you ate a piece of cake.'”