Drug Test

A new program lets Baltimore jail inmates continue methadone treatment while they await trial

August 17, 2008|By Doug Donovan | Doug Donovan,Sun reporter

Every year, an estimated 12,000 heroin addicts are arrested and processed through Baltimore's downtown booking and pretrial jails. And there are hundreds more who arrive treating their addictions with methadone.

But for those who can't make bail, staying behind bars has long meant no methadone - the leading medication to ease painful withdrawal symptoms and a proven strategy to keep addicts off of heroin and clear of criminal lifestyles.

Now, that's changing.

Maryland's new program to dispense methadone to heroin addicts who are held at the Baltimore jail awaiting trial has rapidly grown into one of the nation's largest efforts to deliver the addiction treatment behind bars.

The Maryland Department of Public Safety and Correctional Services launched the effort in January and dispensed methadone to nearly 2,800 people by June 30. Only the New York City jail on Rikers Island provides the medication to a greater number, a federal official said.

The vast majority in Baltimore - 2,478 inmates - received methadone to treat their withdrawal from active heroin addiction. An additional 288 people received it to continue the daily doses they had been getting at methadone clinics before their arrests.

The program is on track to treat about 4,500 heroin addicts by the end of the year. The estimated 7,500 others are released too quickly to obtain the treatment, or they refuse medication.

And correctional officials estimate that the jails will be able to continue methadone for 540 individuals by the end of 2008.

Keeping methadone patients on their medicine while they await trial vastly improves the likelihood that they remain in treatment if they are released on bail or a judge's ruling, officials said. Officials hope the program will reduce crime linked to drug abuse. "The worst thing we can do is disrupt someone's treatment while they're in the middle of care," said Gregory C. Warren, director for substance abuse treatment services for the corrections department. The program also prevents needless suffering from withdrawal, he said.

Danyelle Wallace has experienced the suffering several times, from withdrawing from heroin and methadone after getting arrested. Vomiting. Backaches. Diarrhea.

But when she was arrested in early June for stealing crab meat from a supermarket, she was surprised to learn about the methadone program.

"In the past they weren't medicating anyone and I saw the pain that people was going through trying to detox and kick off the methadone, which was worse than kicking heroin," Wallace, 38, said during an interview in jail last month.

"I am really tired of allowing myself to keep coming to prison with a dope habit, trying to kick it. I made a step to get into a methadone program and I don't want to lose it."

It took nearly three years to start the program because methadone clinic licenses had to be obtained for four facilities: central booking, the men's detention center, the women's jail and the infirmary, Warren said.

Benjamin Brown, Maryland's deputy commissioner for the division of pretrial detention and services, said the delay was partially due to resistance from an institution whose core duty is incarceration, not treatment.

When convicted and sent to long-term placements, inmates are taken off methadone in a detoxification process.

In nearby jurisdictions, policies vary. In Baltimore County, only methadone patients who are arrested and detained on weekends can get access to their medicine. Anne Arundel County's detention facility tapers methadone patients off of their medication, including detainees who are awaiting trial.

Nick Reuter, a senior public health analyst for the U.S. Substance Abuse and Mental Health Services Administration, said Baltimore and Rikers Island are distinctive.

"What's unique is giving methadone treatment to individuals who are in that pre-[trial] phase at all," Reuter said. "Usually when inmates are at that stage in the criminal justice system, no one is thinking about relieving their opioid withdrawal symptoms. It's probably the most important time because that's when the inmate or patient is at the highest level of withdrawal."

In general there has been opposition to giving out a powerful opiate to prisoners, even though it is a medication administered in a supervised setting.

Before the effort started in January, methadone patients had to stop taking their medication and would get kicked out of their clinics while jailed. They would also have to use less effective, anti-nausea medications to ease their opiate withdrawal symptoms.

Barry Branch, 45, was jailed in Baltimore last month after testing positive for cocaine use, which was a probation violation.

The driver for AAA Ice on Belair Road is also a former heroin addict who is being treated with methadone. Branch said he did not get his methadone dose right away in jail but it came fast enough to avoid serious withdrawal.

"I'm just glad it's here," Branch said. "It's good you can go back to your program."

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