A Randomized Trial of Methadone Initiation Prior to Release from Incarceration

ABSTRACT

Individuals who use heroin and illicit opioids are at high risk for infection with human immunodeficiency virus (HIV) and other blood-borne pathogens, as well as incarceration. The purpose of the randomized trial reported here is to compare outcomes between participants who initiated methadone maintenance treatment (MMT) prior to release from incarceration, with those who were referred to treatment at the time of release. Participants who initiated MMT prior to release were significantly more likely to enter treatment postrelease (P < .001) and for participants who did enter treatment, those who received MMT prerelease did so within fewer days (P = .03). They also reported less heroin use (P = .008), other opiate use (P = .09), and injection drug use (P = .06) at 6 months. Initiating MMT in the weeks prior to release from incarceration is a feasible and effective way to improve MMT access postrelease and to decrease relapse to opioid use.

KEYWORDS:

• HIV prevention
• incarceration
• medication-assisted treatment
• methadone

Acknowledgments

This article was supported by the Lifespan/Tufts/Brown Center for AIDS Research (grant P30AI42853), as well as grants K24DA022112, P30DA013868, R01DA18641, and R01DA027211 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The authors would like to acknowledge the wonderful staff at the Miriam: Christina Anastacio, Candelaria Barroso, Chandra Cannon, Maria Garcia, Ricky Lugo, Skye Tirado; the staff at the RIDOC, Dr. Michael Poshkus; and most of all, the participants who volunteered to be part of this study.