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A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release.

ABSTRACT: This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release.A three-group randomized controlled trial was conducted between September 2003 and June 2005.A Baltimore pre-release prison.Two hundred and eleven adult pre-release inmates who were heroin-dependent during the year prior to incarceration.Participants were assigned randomly to the following: counseling only: counseling in prison, with passive referral to treatment upon release (n = 70); counseling + transfer: counseling in prison with transfer to methadone maintenance treatment upon release (n = 70); and counseling + methadone: methadone maintenance and counseling in prison, continued in a community-based methadone maintenance program upon release (n = 71).Addiction Severity Index at study entry and follow-up. Additional assessments at 6 months post-release were treatment record review; urine drug testing for opioids, cocaine and other illicit drugs.Counseling + methadone participants were significantly more likely than both counseling only and counseling + transfer participants to be retained in drug abuse treatment (P = 0.0001) and significantly less likely to have an opioid-positive urine specimen compared to counseling only (P = 0.002). Furthermore, counseling + methadone participants reported significantly fewer days of involvement in self-reported heroin use and criminal activity than counseling only participants.Methadone maintenance, initiated prior to or immediately after release from prison, increases treatment entry and reduces heroin use at 6 months post-release compared to counseling only. This intervention may be able to fill an urgent treatment need for prisoners with heroin addiction histories.

SUBMITTER: Gordon MS

PROVIDER: S-EPMC2582162 | biostudies-literature | 2008 Aug

REPOSITORIES: biostudies-literature

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A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release.

Gordon Michael S MS Kinlock Timothy W TW Schwartz Robert P RP O'Grady Kevin E KE

Addiction (Abingdon, England) 20080801 8

<h4>Aims</h4>This study examined the effectiveness of methadone maintenance initiated prior to or just after release from prison at 6 months post-release.<h4>Design</h4>A three-group randomized controlled trial was conducted between September 2003 and June 2005.<h4>Setting</h4>A Baltimore pre-release prison.<h4>Participants</h4>Two hundred and eleven adult pre-release inmates who were heroin-dependent during the year prior to incarceration.<h4>Intervention</h4>Participants were assigned randomly ...[more]

PMID: 18855822

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Project description:BackgroundOpioid dependence is an increasing public health problem all over the world. Patients with opioid dependence have to receive methadone maintenance therapy (MMT) as replacement therapy for years or even for their entire life. Acupuncture as a kind of therapy has been used to treat substance dependence for many years. Jin's three-needle acupuncture (JTN), a type of acupuncture technique, has been applied to treat various diseases for several decades. However, JTN as an acupuncture technique has not been used to treat patients receiving MMT. Therefore, we designed a randomized controlled trial to evaluate the efficacy and safety of acupuncture as adjunctive therapy for patients receiving MMT.Methods/designThis study is a parallel-arm, randomized controlled trial that aims to evaluate the efficacy and safety of acupuncture as adjunctive therapy for patients receiving MMT. A total of 140 eligible participants who range in age from 18 to 60 years and fulfil the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V), for opiate dependence will be enrolled into this study. All eligible participants will be randomly assigned to the acupuncture group or routine group in a 1:1 allocation ratio. Participants who are enrolled in the acupuncture group will receive MMT and JTN treatment for 30 min per session. Meanwhile, those who are assigned to the routine arm will receive MMT only. All 18 sessions of JTN treatment will be delivered over 6 weeks (3 per week) and followed by a 4-week follow-up period. The primary outcome measure will be the visual analogue scale (VAS) for drug craving and the daily consumption of methadone (DCOM). Secondary outcome measures will include the urine test for opioid use, the 36-item Short Form Survey (SF-36), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II) and Pittsburgh sleep quality index (PSQI). VAS, DCOM, BAI, BDI-II and the urine test for opioid use will be evaluated at baseline, the second week, the fourth week, the sixth week and the tenth week. SF-36 and PSQI will be assessed at baseline, the fourth week, the sixth week and the tenth week.DiscussionThe results of this trial will provide evidence on the efficacy and safety of acupuncture as adjunctive therapy for patients receiving MMT.Trial registrationChinese Clinical Trial Registry ChiCTR1900026357 . Registered on 2 October 2019.

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A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release.

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A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release.

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