A recent study initiated by the Metropolitan Detention Center for Bernalillo County and conducted by the University of New Mexico’s Center on Alcoholism, Substance Abuse, and Addictions (CASAA), found that inmates receiving Methadone Maintenance Treatment (MMT) at the Metropolitan Detention Center typically stayed out of jail longer than inmates who did not receive the treatment.
The MMT program, which was launched at the MDC in November 2005, provides a daily dose of methadone to inmates previously enrolled in a community-based methadone program. The program has come under scrutiny recently regarding its benefits. The study was conducted over a six-month period during 2013 in response to a proposal to discontinue the MMT program.
The study was led by a team of UNM investigators including Distinguished Professor and CASAA Director Barbara McCrady, Sr. Research Scientist Verner Westerberg and graduate assistant Mandy Owens, and a team of researchers at the UNM Institute for Social Research led by Sr. Research Scientist Paul Guerin.
As part of the study, the researchers reviewed published scientific literature; extracted and coded information from medical screening forms completed by staff from Correctional Healthcare Companies when individuals were booked into the MDC; examined rebooking data from the MDC jail management system; collected cost data provided by the County; and analyzed information on return to community MMT programs provided by Recovery Services, the contractor currently responsible for the MMT program.
The study provided information in five areas related to the program including: a statistical meta-analysis of research literature on the efficacy of the use of methadone maintenance in any type of incarceration setting; recidivism rates and reasons for return to jail; cost effectiveness of the program; retention rates in community-based methadone program after MDC release; and a process analysis to assess structural challenges in tracking and assessing the outcomes of inmates involved in the program.
The meta-analysis revealed that the scientific literature has found individuals who did not receive MMT were three times as likely to recidivate, use drugs, or fail to enroll in treatment as those who took MMT while incarcerated.
The recidivism analyses found that the likelihood of inmates being rebooked in the year after release from the MDC was lowest for the general inmate population, nearly 50 percent, followed by the MMT group (53.4 percent), with significantly higher rebooking rates for the alcohol group (68.3 percent) and the group of inmates who had opiate problems and were detoxed at MDC, but were not part of the MMT program (72 percent). The study also showed that methadone group took longer to be rebooked, approximately 275 days, into MDC than those who had an opioid problem who did not receive methadone (236 days) and the alcohol group (229 days), and looked similar to the general MDC population.
Dr. McCrady noted, “From a scientific and statistical standpoint, our research found clear evidence of a positive impact of the MMT program on recidivism for inmates who received methadone while they were incarcerated.”
On average, the researchers found that inmates in the MMT program stayed out of jail nearly 40 days longer than those with opiate problems who were not treated with methadone, and more than 45 days longer than people with alcohol problems not enrolled in a methadone program, which adds up to nearly $2,500 in taxpayer savings per inmate, even when the county’s contribution to the program are included.
Three findings were unexpected according to the researchers. First, the MMT inmates had longer lengths of stay at the MDC, an average of 36 days longer. It was beyond the scope of this evaluation study to examine the reasons for incarceration and sentencing patterns that lead to these differences. The second unexpected finding was that the reasons for re-incarceration did not differ among groups and the majority were for new crimes rather than probation violations or failure to appear charges. Third, the outcomes for inmates undergoing alcohol detoxification were particularly poor in terms of recidivism to the MDC.
Dr. McCrady noted, “We don’t know why the MMT inmates stayed longer. It could be because of differences in their sentences, or because they are trying to clean up legal charges as part of their recovery process.”
In summing up the study, Dr. McCrady said, “the initial purpose of the MMT program was to provide continuity in the care of opiate dependent inmates, with no expectation that the program would affect recidivism. Our findings suggest that the MMT program also has a positive impact in keeping people out of jail. We are hopeful that our analyses will prove useful to policy makers in making decisions about what services are appropriate to provide at the MDC to inmates with opiate and other substance use disorders”