NCJ Number
212564
Journal
Substance Use & Misuse Volume: 40 Issue: 13-14 Dated: 2005 Pages: 1983-1999
Date Published
2005
Length
17 pages
Annotation
This article reviews English-language literature on the use and effectiveness of pharmacological treatments for substance dependence and harm-reduction within correctional populations.
Abstract
The majority of such research has focused on the treatment of opiate abuse and dependence. In the correctional setting, methadone has been used for both maintenance and opioid withdrawal treatment. Methadone maintenance treatment (MMT) for inmates has been used primarily as a harm-reduction strategy to reduce the transmission of bloodborne infections through the injecting of opiates and syringe-sharing among inmates. Although MMT has been found effective in community settings for opioid-dependence treatment and the harm associated with continued drug use, little is known about the effectiveness of this therapy with an incarcerated population. Although MMT is used for opioid withdrawal treatment and maintenance in a number of correctional facilities in Europe and Australia, only one prison system in the United States routinely provides methadone treatment for opioid-dependent inmates (Riker's Island in New York City). Other drugs used to treat opiate dependence are lofexidine, L-alpha-acetyl-methadol (LAAM) buprenorphine/naloxone, and naltrexone. The effects of each of these drugs on opioid dependence and withdrawal are explained, along with where and how each drug is used in a correctional setting. A recent public policy statement by the American Society of Addiction Medicine recommended that all individuals entering jails and prisons be screened for addiction and withdrawal syndromes and that medical withdrawal regimens be implemented when medically appropriate; however, research on effective medical withdrawal regimens for inmates has not been conducted; this is needed to help guide clinical practice. 1 table, a glossary, and 51 references