Plan to End Methadone Use at Albuquerque Jail Prompts Alarm
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Version 0 of 1. ALBUQUERQUE — It has been almost four decades since Betty Jo Lopez started using heroin. Her face gray and wizened well beyond her 59 years, Ms. Lopez would almost certainly still be addicted, if not for the fact that she is locked away in jail, not to mention the cup of pinkish liquid she downs every morning. “It’s the only thing that allows me to live a normal life,” Ms. Lopez said of the concoction, which contains methadone, a drug used to treat opiate dependence. “These nurses that give it to me, they’re like my guardian angels.” For the last six years, the Metropolitan Detention Center, New Mexico’s largest jail, has been administering methadone to inmates with drug addictions, one of a small number of jails and prisons around the country that do so. At this vast complex, sprawled out among the mesas west of downtown Albuquerque, any inmate who was enrolled at a methadone clinic just before being arrested can get the drug behind bars. Pregnant inmates addicted to heroin are also eligible. Here in New Mexico, which has long been plagued by one of the nation’s worst heroin scourges, there is no shortage of participants — hundreds each year — who have gone through the program. In November, however, the jail’s warden, Ramon Rustin, said he wanted to stop treating inmates with methadone. Mr. Rustin said the program, which had been costing Bernalillo County about $10,000 a month, was too expensive. Moreover, Mr. Rustin, a former warden of the Allegheny County Jail in Pennsylvania and a 32-year veteran of corrections work, said he did not believe that the program truly worked. Of the hundred or so inmates receiving daily methadone doses, he said, there was little evidence of a reduction in recidivism, one of the program’s main selling points. “My concern is that the courts and other authorities think that jail has become a treatment program, that it has become the community provider,” he said. “But jail is not the answer. Methadone programs belong in the community, not here.” Mr. Rustin’s public stance has angered many in Albuquerque, where drug addiction has been passed down through generations in impoverished pockets of the city, as it has elsewhere across New Mexico. Recovery advocates and community members argue that cutting people off from methadone is too dangerous, akin to taking insulin from a diabetic. The New Mexico office of the Drug Policy Alliance, which promotes an overhaul to drug policy, has implored Mr. Rustin to reconsider his stance, saying in a letter that he did not have the medical expertise to make such a decision. Last month, the Bernalillo County Commission ordered Mr. Rustin to extend the program, which also relies on about $200,000 in state financing annually, for two months until its results could be studied further. “Addiction needs to be treated like any other health issue,” said Maggie Hart Stebbins, a county commissioner who supports the program. “If we can treat addiction at the jail to the point where they stay clean and don’t reoffend, that saves us the cost of reincarcerating that person,” she said. Hard data, though, is difficult to come by — hence the county’s coming review. Darren Webb, the director of Recovery Services of New Mexico, a private contractor that runs the methadone program, said inmates were tracked after their release to ensure that they remained enrolled at outside methadone clinics. While the outcome was never certain, Mr. Webb said, he maintained that providing methadone to inmates would give them a better chance of staying out of jail once they were released. “When they get out, they won’t be committing the same crimes they would if they were using,” he said. “They are functioning adults.” In a study published in 2009 in The Journal of Substance Abuse Treatment, researchers found that male inmates in Baltimore who were treated with methadone were far more likely to continue their treatment in the community than inmates who received only counseling. Those who received methadone behind bars were also more likely to be free of opioids and cocaine than those who received only counseling or started methadone treatment after their release. The study, led by Timothy W. Kinlock of the Friends Research Institute, did not find a noticeable difference in criminal activity, after inmates were released, between those who received methadone treatment behind bars and those did not. Supporters of methadone treatment in jails also point to the Key Extended Entry Program at Rikers Island, the New York City jail, started in 1987. In that program, about 5,000 inmates a year are given the drug to maintain treatment they were getting on the outside. Another 15,000 are given a 6- to 12-day regimen of methadone so they can detoxify before being released or transferred to facilities that do not use methadone. “We think it is an absolutely normal part of our care,” said Dr. Homer Venters, assistant commissioner for correctional health care at the city’s Department of Health and Mental Hygiene, which finances the program. Still, most jails and prisons do not treat inmates with methadone, according to the National Commission on Correctional Health Care, which promotes better medical care in prisons and supports the treatment. Some wardens are resistant to introducing another narcotic that could be exploited by inmates, said Scott Chavez, the group’s vice president. And there remains a feeling among correctional institutions that it is wiser for prisoners to complete a total detoxification. But Dr. Chavez maintained that methadone treatment helped create a more stable inmate population. “The danger in not managing a situation with addicted inmates is that it makes it much harder to deal with individuals who will basically do anything in the jail to get their hands on drugs,” he said. Mr. Rustin said his guards were accustomed to handling inmates in the throes of withdrawal. The Albuquerque facility, he said, had the most addicts of the three jails he has helped oversee. He also said that the jail’s medical staff had assured him that incoming inmates who were taken off methadone would be safe, however awful their withdrawal. If the program were discontinued, pregnant inmates addicted to opiates would still be allowed methadone for the safety of the unborn children, Mr. Rustin said. In the meantime, he said cost would continue to be an issue. Officials said the county’s share of operating the program will now rise to nearly $40,000 a month because the number of inmates being treated more than doubled during the last several years. On a recent day, a group of female inmates at the jail, all of them recovering heroin addicts, talked about the benefits of methadone, and the deep fear they had of withdrawal if it were taken away. “My body isn’t dying anymore,” said Evangelina Honahnie, 31. “It makes me feel human.” |