Breaking the cycle

August 08, 2005

DRUG ADDICTION is so pervasive in Baltimore that almost any experiment to loosen its grip seems worth applauding. But a relatively new research study that targets heroin-addicted prisoners for methadone treatment is especially promising. Among the keys to its ultimate success are sufficient resources to ensure treatment once prisoners are released and remediation of the behavioral and other issues that could still send former addicts back to prison.

More than 80 percent of inmates in state custody used drugs or alcohol, and some 55 percent to 60 percent are addicted. Some can continue their habit in prison with contraband substances, but smuggled prison drugs are not enough to sustain serious addicts. And some prisoners are able to suspend their habits by being forced to go cold turkey.

Still, the lure of heroin is powerful, and studies have shown that most addicted inmates relapse within a month of being released. It's time to try something different.

Under a new five-year study funded by the National Institute on Drug Abuse (NIDA), about 60 inmates at the Metropolitan Transition Center, a state prison, will be given methadone, the heroin substitute, for about six months before being released. Friends Research Institute, a local organization that administers health-related reports, and Man Alive, which runs methadone clinics, are also part of the study.

It's a bold move because methadone, which also can be addictive, has rarely been used behind bars. In addition to the inmates receiving methadone, 60 inmates will receive counseling with the promise of admission into a methadone program upon release and another 60 will receive only counseling. Given the potential for quick relapses, it's critical to get addicted offenders into community-based treatment programs immediately upon release.

While the experiment has shown some promise in the first year, it's clear that more resources are needed for treatment. Baltimore needs slots to treat about 15,000 more addicts than can now be served. Researchers and public safety, public health and other officials should come together to determine how many ex-offenders can be helped by methadone clinics, how many need more-intense residential treatment and how many need treatment and additional support services, such as housing, job training and medical, mental health and education services.

Officials can also consider giving inmates buprenorphine, a more expensive but often more effective heroin antidote that Congress has made easier for doctors to dispense. Treatment should also include effective counseling to deal with anger management and antisocial behavior that might cause even recovering addicts to become repeat offenders.

This comprehensive approach will surely cost more than the $500,000 being provided by NIDA. State and city officials need to secure additional public and private support to give this bold experiment a fighting chance to break the cycle of drugs and crime.

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