Methadone prescribing in local prisons in England

Abstract

Purpose – The purpose of this paper is to evaluate some of the wider aims and potential consequences of maintaining remand and short-term prisoners on methadone, rather than providing them with a rapid detoxification on first reception into prison. Consideration is given to the effects of methadone prescribing on treatment engagement; drug-related violence; treatment choice, including detoxification, maintenance and reduction doses; recidivism; and through care. Design/methodology/approach – The author draws on qualitative data gathered during a wider study involving drug-using prisoners and prison drug workers exploring the influence of the therapeutic working alliance on outcomes in prison-based drug treatment. Findings – Whilst participants reported advantages to the prescribing of methadone in prisons, such as reduced levels of bullying and drug-related violence in the prisons, they were also critical of many aspects of methadone prescribing which were intended to increase treatment choice, but in pra...