High dose methadone reduces criminal recidivism in opiate addicts

Inmates accepting high dose (greater than or equal to 60 mg) and low dose m ethadone therapy were identified between 1/1/96 and 7/31/97 in New York Cit y's Correctional system. We studied the duration between release to the com munity from the first incarceration in the study period until reincarcerati on or study's end to assess the impact of the higher dose on the criminal r ecidivism 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, gend er and race, a Cox proportional hazard model demonstrated a 13% reduction i n hazard for reincarceration for those electing high dose. While a fixed hi gher dose demonstrably reduced recidivism, we advocate routine methadone pl asma level monitoring to adjust doses to achieve "blocking dose plasma leve ls" both in the general community and the jail.