High dose methadone reduces criminal recidivism in opiate addicts

Inmates accepting high dose (greater than or equal to 60 mg) and low dose methadone therapy were identified between 1/1/96 and 7/31/97 in New York City's Correctional system. We studied the duration between release to the community from the first incarceration in the study period until reincarceration or study's end to assess the impact of the higher dose on the criminal recidivism rate. inmates discharged on high dose methadone were less likely to return to jail than were those on low dose (P<.002) with median time to reincarceration of 253 and 187 days respectively. Controlling for age, gender and race, a Cox proportional hazard model demonstrated a 13% reduction in hazard for reincarceration for those electing high dose. While a fixed higher dose demonstrably reduced recidivism, we advocate routine methadone plasma level monitoring to adjust doses to achieve "blocking dose plasma levels" both in the general community and the jail.