No Methadone Therapy for Addicts in US Prisons


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 all over the rest of the world, including almost all the prisoners in the European Union. We were thinking of the so-called “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” 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. 

Sometimes methadone gets black-marketed in prison. This problem can be attacked 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." 

As Csete and others explain, withholding methadone from imprisoned addicts is like refusing to give diabetic prisoners insulin. Wapner quotes a study that found the cost benefit to taxpayers was $4.00 for every dollar spent on methadone therapy. “In other words,” she writes,  “drug addicts cost the country more than recovering drug addicts.” Prisons are missing a prime opportunity for turning the former into the latter.


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