McKenzie Michelle, Nunn Amy, Zaller Nickolas D, Bazazi Alexander R, Rich Josiah D
The Miriam Hospital, Providence, Rhode Island, USA.
J Opioid Manag. 2009 Jul-Aug;5(4):219-27. doi: 10.5055/jom.2009.0024.
More than 2.4 million people are currently incarcerated in the United States, many as a result of drug-related offenses. In addition, more than 200,000 active heroin addicts pass through the correctional system annually. New evidence suggests that both providing prisoners with referrals for community-based methadone programs and providing methadone prior to release reduces recidivism and adverse health and social consequences associated with drug use. This article reports the programmatic challenges associated with initiating methadone treatment in the Rhode Island correctional system. Significant obstacles to implementing methadone treatment include: stigma associated with pharmacological treatment, misconceptions regarding the nature of opioid addiction, logistics of control and storage of methadone, increased work load for nursing staff and general safety and control concerns. The authors discuss strategies to address these barriers and conclude that providing methadone prior to inmate release is a feasible intervention with the potential to mitigate drug-related health and social harms.
目前，美国有超过240万人被监禁，其中许多人是因与毒品相关的罪行入狱。此外，每年有超过20万活跃的海洛因成瘾者进出惩教系统。新证据表明，为囚犯提供转介到社区美沙酮项目的机会以及在释放前提供美沙酮，均可减少累犯以及与吸毒相关的不良健康和社会后果。本文报告了在罗德岛惩教系统启动美沙酮治疗所面临的项目挑战。实施美沙酮治疗的重大障碍包括：药物治疗相关的污名化、对阿片类药物成瘾本质的误解、美沙酮管控和储存的后勤问题、护理人员工作量增加以及一般安全和管控问题。作者讨论了应对这些障碍的策略，并得出结论，在囚犯释放前提供美沙酮是一种可行的干预措施，有可能减轻与毒品相关的健康和社会危害。
