Jail management of arrestees/inmates enrolled in community methadone maintenance programs

doi:10.1093/jurban/jth147

J Urban Health. 2004 December; 81(4): 645–654.

doi: 10.1093/jurban/jth147

PMCID: PMC3455924

Jail management of arrestees/inmates enrolled in community methadone maintenance programs

Kevin Fiscella,^1,² Andrew Moore,⁴ Judith Engerman,¹ and Sean Meldrum¹

¹Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York

²Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York

⁴University of Rochester School of Medicine and Dentistry, Rochester, New York

³Family Medicine Center, 1381 South Avenue, 14620-2399 Rochester, NY

Kevin Fiscella, Email: Kevin_Fiscella/at/urmc.rochester.edu.

Corresponding author.

This article has been cited by other articles in PMC.

Abstract

Anecdotal evidence suggests that many jails fail to adequately detoxify arrestees/inmates who are enrolled in methadone programs, but there are few empirical data. The objective of this study was to assess how jails manage arrestees/inmates enrolled in methadone programs. A national survey of 500 jails in the United States was conducted. Surveys were mailed to the 200 largest jails in the country in addition to a random sample of 300 of the remaining jails (10% sample). Jails were specifically asked about management of opiate dependency among arrestees/inmates enrolled in methadone programs. Weighted logistic regression analyses were conducted to assess predictors of continuing methadone during incarceration and use of recommended detoxification protocols. Among the 245 (49%) jails that responded, only 1 in 4 (27%) reported they contacted the methadone programs regarding dose, and only 1 in 8 (12%) continued methadone during the incarceration. Very few (2%) jails used methadone or other opiates for detoxification. Most used clonidine. However, half (48%) of jails failed to use clonidine, methadone, or other opiates to detoxify inmates from methadone. Weighted logistic regression models showed that moderately large jails and those located in the South and Midwest were significantly more likely to continue methadone. Very large jails, those with an estimated prevalence of opiate dependence of 6%–10% among arrestees/inmates, and those located in the Northeast were significantly more likely to use recommended detoxification protocols. Very few jails provided continuous treatment to arrested persons on methadone, and half failed to detoxify arrestees/ inmates using recommended protocols. These practices jeopardize the health and wellbeing of persons enrolled in methadone programs and underscore the need for uniform national policies within jails.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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