Yale University School of Medicine, Section of Infectious Diseases, New Haven, CT 06510, USA.
J Subst Abuse Treat. 2013 May-Jun;44(5):502-5. doi: 10.1016/j.jsat.2012.10.005. Epub 2013 Feb 22.
The World Health Organization classifies methadone as an essential medicine, yet methadone maintenance therapy remains widely unavailable in criminal justice settings throughout the United States. Methadone maintenance therapy is often terminated at the time of incarceration, with inmates forced to withdraw from this evidence-based therapy. We assessed whether these forced withdrawal policies deter opioid-dependent individuals in the community from engaging methadone maintenance therapy in two states that routinely force inmates to withdraw from methadone (N = 205). Nearly half of all participants reported that concern regarding forced methadone withdrawal during incarceration deterred them engaging methadone maintenance therapy in the community. Participants in the state where more severe methadone withdrawal procedures are used during incarceration were more likely to report concern regarding forced withdrawal as a treatment deterrent. Methadone withdrawal policies in the criminal justice system may be a broader treatment deterrent for opioid-dependent individuals than previously realized. Redressing this treatment barrier is both a health and human rights imperative.
世界卫生组织将美沙酮列为基本药物，但美沙酮维持疗法在美国刑事司法系统中仍广泛无法获得。美沙酮维持疗法通常在监禁时终止，囚犯被迫停止这种基于证据的治疗。我们评估了这些强制戒毒政策是否会阻止社区中依赖阿片类药物的个体在两个经常强制囚犯停止美沙酮治疗的州接受美沙酮维持治疗（N=205）。几乎一半的参与者报告说，担心在监禁期间被迫美沙酮戒断会阻止他们在社区接受美沙酮维持治疗。在监禁期间使用更严重的美沙酮戒断程序的州的参与者更有可能报告担心强制戒断作为治疗障碍。刑事司法系统中的美沙酮戒断政策可能对依赖阿片类药物的个体构成比以前认识到的更广泛的治疗障碍。纠正这种治疗障碍既是健康和人权的当务之急。
