Methadone prescribing in local prisons in England

Abstract

Purpose

The purpose of this paper is to evaluate some of the wider aims and potential consequences of maintaining remand and short-term prisoners on methadone, rather than providing them with a rapid detoxification on first reception into prison. Consideration is given to the effects of methadone prescribing on treatment engagement; drug-related violence; treatment choice, including detoxification, maintenance and reduction doses; recidivism; and through care.

Design/methodology/approach

The author draws on qualitative data gathered during a wider study involving drug-using prisoners and prison drug workers exploring the influence of the therapeutic working alliance on outcomes in prison-based drug treatment.

Findings

Whilst participants reported advantages to the prescribing of methadone in prisons, such as reduced levels of bullying and drug-related violence in the prisons, they were also critical of many aspects of methadone prescribing which were intended to increase treatment choice, but in practice, often restricted choice. Drug workers reported that some drug-using prisoners were harder to engage with treatment when they were maintained on methadone.

Research limitations/implications

Data were gathered from two “local” prisons in the same geographical area, and as such, the findings may not be applicable across all prison service establishments. Nonetheless, they highlight important considerations and wider policy implications that could be applicable.

Originality/value

Some previously unreported consequences of methadone prescribing in prisons are discussed, including its potential to increase, rather than decrease heroin use and accompanying crime.

Citation

Asher, H. (2013), "Methadone prescribing in local prisons in England", Drugs and Alcohol Today, Vol. 13 No. 4, pp. 234-243. https://doi.org/10.1108/DAT-04-2013-0018