Albuquerque Journal

End­ing Jail Methadone May Have Own Costs

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The de­ci­sion by Ber­nalillo County’s Met­ro­pol­i­tan De­ten­tion Cen­ter to stop pro­vid­ing methadone to heroin-ad­dicted in­mates has a get-tough-on-crime as well as a cost-cut­ting ap­peal. But it could also have un­in­tended con­se­quences — ex­pen­sive ones in terms of con­tra­band, safety and hu­mane treat­ment at the jail.

Last week MDC stopped pro­vid­ing methadone to new in­mates and be­gan step­ping cur­rent in­mates down in dosage, with zero to be pro­vided in the new year. The plan drew crit­i­cism, so much so it was put on hold this week while the jail au­dits po­ten­tial fall­out.

MDC Chief Ra­mon Rustin has ar­gued that end­ing the jail’s methadone pro­gram is in part a bud­get con­cern — the jail has paid a con­trac­tor about $160,000 since 2010 to ad­min­is­ter the drug. And he says it will have the added ben­e­fit of dis­cour­ag­ing drug ad­dicts from com­mit­ting crimes and get­ting ar­rested be­cause they know they will have to go through with­drawal in jail.

In a per­fect world where junkies make smart de­ci­sions, maybe. But this is New Mex­ico, which has the na­tion’s high­est death rate from drug over­doses. Where ad­dic­tion is so preva­lent that Med­i­caid cov­er­age was ex­panded this fall to cover methadone to treat peo­ple ad­dicted to heroin and painkiller­s. And where the state prison sys­tem is busy at­tack­ing the smug­gling of Subox­one — the next gen­er­a­tion choice of heroin with­drawal treat­ment.

MDC guards have voiced con­cerns about in­creased vi­o­lence if methadone is banned. Union pres­i­dent Stephen Perkins says dis­tressed heroin ad­dicts can “be­come very vi­o­lent and ag­gres­sive.” They also may end up in a fe­tal po­si­tion, cry­ing, sweat­ing, vom­it­ing, defe­cat­ing and likely be­ing beaten sense­less by other in­mates who be­come sick of their sick­ness. The over­crowded MDC has a not-tood­is­tant his­tory of bru­tal in­mate-on-in­mate vi­o­lence — it’s im­por­tant to con­sider both sce­nar­ios and pre­pare for them if this pol­icy change is likely to add to the prob­lem.

Fi­nally, there is the ques­tion of hu­mane treat­ment. It could be ar­gued that forc­ing ad­dicted/in-treat­ment in­mates serv­ing short stints in the county lockup to go cold turkey off heroin or methadone doesn’t meet that stan­dard. A pro­posed step-down pro­gram would make more sense.

The jail is us­ing the au­dit to sort out the le­gal, med­i­cal and ef­fi­cacy is­sues of con­tin­u­ing to pro­vide methadone to in­mates — 87 cur­rently. It is im­por­tant of­fi­cials also con­sider the is­sues of con­tra­band, safety and hu­man­ity for a more com­pete pic­ture of the bot­tom line.

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