Assisting opiate addicted offenders upon re-entry: 12 month outcomes for a methadone linkage program

BACKGROUND: Twenty-three percent of state prisoners in the US have a history of opiate addiction. Methadone maintenance treatment (MMT) has been shown to be an effective treatment strategy to decrease drug use, HIV risk behaviors and criminal activity. Opiate addicted offenders re-entering the community are disproportionately affected by risk factors leading to relapse, overdose, blood-borne disease and recidivism. We are implementing a SAMHSA funded service initiative to link offenders entering the community to MMT.

METHODS: Project staff screen potential clients at the Rhode Island Department of Corrections. We make logistical arrangements for entering MMT upon release, provide partial financial assistance for MMT for 24 weeks, and social service referrals. Clients are followed for one year. Data are collected at baseline, six, and twelve months. Baseline occurs after initiation in community MMT.

RESULTS: As of September 2006 we enrolled 381 clients and completed 232 12-month interviews (87% follow-up). At six months 55% were enrolled in MMT and at 12 months 44% were enrolled in MMT. The proportion of participants reporting injecting in the past 30 days, sharing, heroin use and other drug use significantly decreased at 12 months. The proportion of participants reporting being employed and receiving pension significantly increased at 12 months.

CONCLUSIONS: Number of enrollees, length of stay in treatment, decreased risk behaviors suggest that linkage to MMT post release is feasible and beneficial. Future work will be a randomized trial of the program to demonstrate efficacy and initiating methadone during incarceration to facilitate treatment entry post release.