© 2005 Behavioral Health Research Institute of the Southwest
612 Encino Place NE / Albuquerque, NM 87102 / 505.244.3099 / www.bhrcs.org

“Effects of a New Policy Allowing Methadone Maintenance Treatment in a Large, New Mexico Jail on Inmate Infractions, Medical Visits, and Recidivism.”
Sandra C. Lapham, MD, MPH, Principal Investigator
Behavioral Health Research Center of the Southwest
Albuquerque, New Mexico

In 1997, the Bernalillo County Detention Center (BCDC), Albuquerque, New Mexico, stopped administering methadone to incarcerated arrestees enrolled in methadone maintenance treatment (MMT) or other opiate replacement therapy (ORT). However, in a recent development, officials at BCDC and the NM Department of Health have agreed to establish and staff an innovative program—a public health clinic at the soon-to-be-opened newly-constructed jail facility. The public health clinic will re-institute MMT, and may eventually expand ORT. Harm reduction also will take place by integrating offenders into the public health system both in the jail (MMT, immunizations, family planning, counseling, and sexually-transmitted disease treatment) and following release (linkage with methadone clinics, aftercare, and syringe exchange programs).

The new clinic will identify and administer MMT to all inmates booked into the jail who are enrolled in a methadone maintenance program and have received methadone from their program within the past 2 weeks. The goals of the in-jail MMT program include: (1) educate inmates and staff about the role of harm reduction and MMT in treating opiate addiction; (2) administer methadone or other MMT to all inmates currently enrolled in methadone maintenance programs; (3) reduce need for medical intervention resulting from methadone withdrawal; (4) reduce rule infractions; (5) facilitate client participation in MMT following release; (6) reduce post-release heroin use; and for those who continue heroin use, to increase participation in the syringe exchange program after release; and (7) reduce re-arrest.

The evaluation will focus on the MMT portion of the clinic. A process evaluation will categorize and quantify the unfolding events and timeline, including the obstacles and successes experienced as this program gets underway. A survey will investigate the knowledge, attitudes, and opinions of jail personnel and medical staff regarding methadone therapy before and after program implementation. An outcome evaluation will be conducted to analyze in-jail infraction and medical intervention rates, and recidivism after release.

The establishment of this clinic presents a rare opportunity to test the efficacy of harm reduction policies in one of the neediest populations within our society. The proposed study will evaluate the effects of providing methadone maintenance therapy, on inmates and jail operations. If this approach is shown to be effective it could serve as a model for the rest of the state and the nation.