Garnett P McMillan1, Sandra Lapham, Michael Lackey. 1. Behavioral Health Research Center of the Southwest, Center of the Pacific Institute for Research and Evaluation, Albuquerque, NM 87102, USA. gmcmillan@bhrcs.org <gmcmillan@bhrcs.org>
Abstract
AIMS: To evaluate the effects of a jail-based continuation of methadone maintenance therapy (MMT) on subsequent inmate recidivism risks. DESIGN: Prospective, longitudinal, observational study. SETTING: A large, Southwestern United States jail that continues MMT for heroin-addicted inmates on MMT at the time of booking. PARTICIPANTS: A total of 589 inmates booked between 22 November 2005 (the start date for the MMT program) and 31 October 2006. MEASUREMENTS: The outcome measure was time from release to subsequent re-booking in the jail. Predictors included binary dosing with methadone in the jail, final dose received (mg), age, gender, race/ethnicity, previous bookings and days in jail. FINDINGS AND CONCLUSIONS: Random effects Weibull proportional hazards models were fit to the recidivism times to estimate the impact of treatment with MMT in the jail on re-booking risks. There was no statistically significant effect of receiving methadone in the jail or dosage on subsequent recidivism risks (hazard ratio = 1.16; 95% confidence interval = 0.8-1.68). Offering jail-based MMT does not increase recidivism risks by eliminating the deterrent effect of imposed withdrawal, nor does it reduce recidivism in this high-risk population.
AIMS: To evaluate the effects of a jail-based continuation of methadone maintenance therapy (MMT) on subsequent inmate recidivism risks. DESIGN: Prospective, longitudinal, observational study. SETTING: A large, Southwestern United States jail that continues MMT for heroin-addicted inmates on MMT at the time of booking. PARTICIPANTS: A total of 589 inmates booked between 22 November 2005 (the start date for the MMT program) and 31 October 2006. MEASUREMENTS: The outcome measure was time from release to subsequent re-booking in the jail. Predictors included binary dosing with methadone in the jail, final dose received (mg), age, gender, race/ethnicity, previous bookings and days in jail. FINDINGS AND CONCLUSIONS: Random effects Weibull proportional hazards models were fit to the recidivism times to estimate the impact of treatment with MMT in the jail on re-booking risks. There was no statistically significant effect of receiving methadone in the jail or dosage on subsequent recidivism risks (hazard ratio = 1.16; 95% confidence interval = 0.8-1.68). Offering jail-based MMT does not increase recidivism risks by eliminating the deterrent effect of imposed withdrawal, nor does it reduce recidivism in this high-risk population.
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