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Heroin Addiction and Related Clinical Problems: 2004, 06, 2 (pages: 53 - 72)

Clinical foundations for the use of methadone in jail

Maremmani I., Pacini M., Lovrecic M.

Summary: Interventions against drug addiction aim to achieve a satisfactory level of individual well-being, which does not vary despite different starting conditions. Spending time in jail is a common experience in the personal history of addicts; in response, the prison system should implement medical skills that have proven effective in ensuring behavioural control and health preservation for free individuals. Agonist maintenance by methadone or buprenorphine is feasible within prison walls, applying the same criteria that are adopted outside. Firstly, agonist drugs allow a safer relationship with the jailed addict. In addition, they improve the prospects for early release: therapies that started behind bars pave the way towards a life of freedom. Different schedules are suitable for different grades of addictive severity. Less severe patients may be forced out of an ill-chosen style of life as a free individual into an option of therapeutic parole. Hard-core addicts may benefit from the isolation of prison life, in so far as they are initiated and become stabilized on therapeutic regimens during custody. This solution will at least grant them a better quality of prison life. On this view, the prison system can play a crucial role in leading addicts towards therapy, mental health and social adjustment.