A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release

Drug Alcohol Depend. 2018 Mar 1;184:57-63. doi: 10.1016/j.drugalcdep.2017.11.023. Epub 2018 Jan 31.


Recently, incarcerated individuals are at increased risk of opioid overdose. Methadone maintenance treatment (MMT) is an effective way to address opioid use disorder and prevent overdose; however, few jails and prisons in the United States initiate or continue people who are incarcerated on MMT. In the current study, the 12 month outcomes of a randomized control trial in which individuals were provided MMT while incarcerated at the Rhode Island Department of Corrections (RIDOC) are assessed. An as-treated analysis included a total of 179 participants-128 who were, and 51 who were not, dosed with methadone the day before they were released from the RIDOC. The results of this study demonstrate that 12 months post-release individuals who received continued access to MMT while incarcerated were less likely to report using heroin and engaging in injection drug use in the past 30 days. In addition, they reported fewer non-fatal overdoses and were more likely to be continuously engaged in treatment in the 12-month follow-up period compared to individuals who were not receiving methadone immediately prior to release. These findings indicate that providing incarcerated individuals continued access to MMT has a sustained, long-term impact on many opioid-related outcomes post-release.

Keywords: Incarceration; Methadone maintenance treatment.

Publication types

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

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Female
  • Follow-Up Studies
  • Heroin Dependence / epidemiology
  • Heroin Dependence / prevention & control
  • Heroin Dependence / psychology
  • Humans
  • Male
  • Methadone / administration & dosage*
  • Opiate Substitution Treatment / methods
  • Opiate Substitution Treatment / psychology
  • Opiate Substitution Treatment / trends*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / psychology
  • Prisoners* / psychology
  • Prisons / trends*
  • Random Allocation
  • Rhode Island / epidemiology
  • Substance Abuse, Intravenous / epidemiology
  • Substance Abuse, Intravenous / prevention & control
  • Substance Abuse, Intravenous / psychology
  • Substance Withdrawal Syndrome* / epidemiology
  • Substance Withdrawal Syndrome* / psychology
  • Time Factors
  • United States


  • Analgesics, Opioid
  • Methadone