A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release

Addiction. 2008 Aug;103(8):1333-42. doi: 10.1111/j.1360-0443.2008.002238.x.


Aims: This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release.

Design: A three-group randomized controlled trial was conducted between September 2003 and June 2005.

Setting: A Baltimore pre-release prison.

Participants: Two hundred and eleven adult pre-release inmates who were heroin-dependent during the year prior to incarceration.

Intervention: Participants were assigned randomly to the following: counseling only: counseling in prison, with passive referral to treatment upon release (n = 70); counseling + transfer: counseling in prison with transfer to methadone maintenance treatment upon release (n = 70); and counseling + methadone: methadone maintenance and counseling in prison, continued in a community-based methadone maintenance program upon release (n = 71).

Measurements: Addiction Severity Index at study entry and follow-up. Additional assessments at 6 months post-release were treatment record review; urine drug testing for opioids, cocaine and other illicit drugs.

Findings: Counseling + methadone participants were significantly more likely than both counseling only and counseling + transfer participants to be retained in drug abuse treatment (P = 0.0001) and significantly less likely to have an opioid-positive urine specimen compared to counseling only (P = 0.002). Furthermore, counseling + methadone participants reported significantly fewer days of involvement in self-reported heroin use and criminal activity than counseling only participants.

Conclusions: Methadone maintenance, initiated prior to or immediately after release from prison, increases treatment entry and reduces heroin use at 6 months post-release compared to counseling only. This intervention may be able to fill an urgent treatment need for prisoners with heroin addiction histories.

Trial registration: ClinicalTrials.gov NCT00378079.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Baltimore
  • Counseling / methods*
  • Follow-Up Studies
  • Heroin Dependence / rehabilitation*
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • Narcotics / therapeutic use*
  • Outcome Assessment, Health Care
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prisoners* / statistics & numerical data
  • Substance Abuse Treatment Centers


  • Narcotics
  • Methadone

Associated data

  • ClinicalTrials.gov/NCT00378079