Ending Jail Methadone May Have Own Costs

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.