Methadone therapy can help opiate-addicted inmates recover, and many countries have embraced it. But the U.S. hasn't.
A drug addict receives a cup of methadone at a hospital in Nanjing, China. Sean Yong/Reuters
Considering the high rates of opiate dependency among American prisoners (heroin and OxyContin), short-term jails seem like an ideal place for methadone programs. Several decades' worth of evidence confirm that methadone treatment works. Also well documented is the link between opiate use and crime. According to one National Institutes of Health report, over 95 percent of heroin addicts committed a crime during an 11-year time period. In New York, 12 to 25 percent of arrested felons tested positive for opiate use upon booking in 2003. The NIH says that treating opiate dependence markedly reduces criminal activity.
But precious few correctional facilities have taken the bold step of opening methadone maintenance treatment (MMT) programs, and very few plan to. Why?
The best-known example of an in-prison methadone program is at New York City's Rikers Island Correctional Facility. The facility's Key Extended Entry Program, begun in 1987, offers methadone to addicts charged with misdemeanors and ushers them into a community methadone program upon release (after a prison stay of about 35 days). The Rikers program has led to a significant reduction in criminal recidivism—repeated similar offenses—and a high rate of continued methadone therapy upon release. A few other facilities in the U.S. have similar programs, although some offer methadone only to people who were already in treatment prior to their arrest. In contrast, most prison systems in the European Union offer these sorts of treatments, as do others throughout the world, including some countries with very conservative governments.