Is a comprehensive methadone program within the jail system effective at lowering rates of recidivism in opiate-dependent pregnant women inmates?
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PublisherThe University of Arizona.
DescriptionA Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
AbstractThe aim of this study was to demonstrate that a comprehensive methadone program within the jail system, bridged to the community on jail release, is effective at lowering rates of recidivism in opiate-dependent pregnant women. We addressed the gap in the literature evaluating the efficacy of methadone therapy specifically in women prisoners, while focusing on pregnant women prisoners. There have been very few published studies evaluating a comprehensive methadone program (CMP) in the prison setting. A CMP in the prison setting, such as the one in place at Estrella Jail in Maricopa County, Arizona, includes patient-specific dose adjustment, patient education, provider evaluation, and bridging opportunities to community methadone clinics post-discharge from jail. We performed a retrospective chart review of all women who have gone through the comprehensive methadone program in the past four years at Estrella Jail in Phoenix, Arizona. Data was used from the pregnant patients who participated in a CMP at Estrella Jail. Our primary result compared recidivism rates within six months in three groups - those in Years One and Two, Year Three, and Year Four of the program. Demographics including age range, race, booking year, and length of incarceration were also compared among the groups. We hypothesized that women in Year Four of the program, who received comprehensive education and a dose-adjustment of their methadone, would have lower rates of recidivism among all demographics, compared to women in Years One and Two of the program. There were a total of 199 program participants, 28.1% were incarcerated during Years One and Two combined, 37.2% during Year 3, and 34.7% during Year 4. The mean age of these women was 28.3. 76.4% of patients were Caucasian. 22 total women (11.1%) were reincarcerated, 40.9% during Years 1 and 2 combined, 22.7% during Year 3, and 36.4% during Year 4. With this data, we have provided evidence that a comprehensive methadone program can have a far-reaching public health impact. Through this program, we hope to have shed more light on methadone therapy in pregnant prisoners. The impact of this study could significantly impact the decision of other correctional health facilities to begin a methadone program for their prisoners, women prisoners, and/or pregnant prisoners. We hope to bring awareness to this treatment method, which is a promising option for opioid dependent prisoners