Westerberg Verner S, McCrady Barbara S, Owens Mandy, Guerin Paul
Center on Alcoholism, Substance Abuse and Addictions, The University of New, Mexico, 2650 Yale Blvd. SE, Albuquerque, NM, 87106.
Center on Alcoholism, Substance Abuse and Addictions, The University of New, Mexico, 2650 Yale Blvd. SE, Albuquerque, NM, 87106.
J Subst Abuse Treat. 2016 Nov;70:1-6. doi: 10.1016/j.jsat.2016.07.007. Epub 2016 Jul 18.
Because it is not common in the U.S. for jails to allow inmates to continue opioid medications that have been started in the community, we aimed to assess whether inmates maintained on methadone showed different rates of recidivism, lengths of incarceration, and types of offenses than other incarcerated groups. We also analyzed rates of return to home clinics after release. In order to answer these questions this study used extant data from 960 adult inmates in a large metropolitan detention center who were in 1 of 4 groups: general population with no known substance use disorders, alcohol detoxification, methadone maintenance (MMT), and opioid detoxification. Recidivism was assessed for 1 year after release. Data were collected from medical screening forms and jail databases and included demographic variables, dates of admission and release, number of doses and total dosage of methadone if applicable, reason for incarceration, and the date of rebooking and nature of offense, if it occurred. There was a significant difference in time to rebooking, F (3956)=13.32, p=.00, with the MMT group taking longer to be rebooked (275.6 days) than the opioid (236.3 days) and alcohol detoxification groups (229.3 days), but not the general population group (286.2 days). Survival analysis indicated significantly better survival without rebooking in the MMT and general population groups than the alcohol and opioid detoxification groups. There also were differences in length of incarceration, F (3, 954)=9.02, p=.00, with the MMT group being incarcerated longer than other substance using groups; and in misdemeanor vs. felony rebooking offenses, χ [3]=31.29, p<.01, with the opioid detoxification group being more likely to have a felony rebooking than the general or alcohol groups. In a separate analysis, data from 137 MMT clients, who were not precisely the same clients who were involved in other analyses reported in this article, indicated that over 97% returned to their home methadone clinics after incarceration. In summary, inmates who had been allowed to be maintained on methadone started in the community displayed a significantly longer time to be rearrested than inmates undergoing opioid or alcohol detoxification, but not inmates without substance use disorders. When they were rebooked, they were as likely as the opioid detoxification group to be rearrested for felony offenses.
由于在美国监狱通常不允许囚犯继续服用在社区中已开始使用的阿片类药物，我们旨在评估维持美沙酮治疗的囚犯与其他被监禁群体相比，是否有不同的累犯率、监禁时长和犯罪类型。我们还分析了释放后返回家庭诊所的比率。为了回答这些问题，本研究使用了来自一个大型都市拘留中心960名成年囚犯的现有数据，这些囚犯分属4组中的1组：无已知物质使用障碍的普通人群、酒精解毒组、美沙酮维持治疗（MMT）组和阿片类药物解毒组。在释放后1年评估累犯情况。数据从医疗筛查表格和监狱数据库收集，包括人口统计学变量、入院和释放日期、适用时美沙酮的剂量数和总剂量、监禁原因以及重新登记日期和犯罪性质（如果发生的话）。重新登记的时间存在显著差异，F(3,956)=13.32，p = 0.00，MMT组重新登记所需时间（275.6天）比阿片类药物组（236.3天）和酒精解毒组（229.3天）长，但不比普通人群组（286.2天）长。生存分析表明，MMT组和普通人群组在不重新登记方面的生存率显著高于酒精和阿片类药物解毒组。监禁时长也存在差异，F(3,954)=9.02，p = 0.00，MMT组的监禁时间比其他物质使用组更长；在轻罪与重罪重新登记犯罪方面，χ[3]=31.29，p < 0.01，阿片类药物解毒组比重罪组或酒精组更有可能因重罪重新登记。在另一项分析中，137名MMT客户的数据（这些客户与本文其他分析中涉及的客户不完全相同）表明，超过97%的人在监禁后返回了他们的家庭美沙酮诊所。总之，在社区中开始服用美沙酮并被允许维持治疗的囚犯，其再次被捕的时间比接受阿片类药物或酒精解毒治疗的囚犯显著更长，但比无物质使用障碍的囚犯并非如此。当他们被重新登记时，他们与阿片类药物解毒组因重罪再次被捕的可能性相同。
