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Compulsory supervision and methadone maintenance

D P Desmond1, J F Maddux

  • 1Department of Psychiatry, University of Texas Health Science Center at San Antonio 78284-7792, USA.

Journal of Substance Abuse Treatment
|January 1, 1996
PubMed
Summary
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Methadone maintenance treatment outcomes were similar for patients on probation or parole compared to voluntary patients. Compulsory supervision did not significantly worsen retention or productivity, but did increase incarceration rates slightly.

Area of Science:

  • Addiction medicine
  • Public health
  • Criminal justice research

Background:

  • Methadone maintenance treatment (MMT) is a cornerstone for opioid use disorder.
  • Individuals with opioid use disorder often interact with the criminal justice system, leading to probation or parole.
  • Concerns exist regarding the impact of compulsory supervision on MMT outcomes.

Purpose of the Study:

  • To compare treatment outcomes of patients in MMT under compulsory supervision versus voluntary admission.
  • To determine if probation or parole status negatively affects MMT effectiveness.

Main Methods:

  • A cohort study comparing 296 subjects on probation/parole with 314 voluntary subjects in MMT.
  • Both groups received equivalent treatment services.

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  • One-year follow-up assessing retention, productive activity, and incarceration rates.

    • Main Results:

    • The compulsory supervision group showed slightly worse outcomes in retention and productive activity.
    • Incarceration rates were higher in the compulsory supervision group (mean 2.1 months vs. 0.7 months).
    • Higher discharge rates for incarceration in the compulsory group, and for noncompliance in the voluntary group.

    Conclusions:

    • Findings do not support excluding individuals on probation or parole from MMT.
    • Compulsory supervision appears to have a minimal negative impact on most MMT outcomes.
    • Policy implications suggest continued access to MMT for justice-involved opioid users.