Institutional Adjustment of Methadone Maintenance Treatment Program (MMTP) Participants: A Comparative Study

Why we are doing this study

Few studies have examined the impact of Methadone Maintenance Treatment Program (MMTP) participation on the institutional adjustment of opioid dependent offenders. Institutional adjustment, or how inmates adjust to and cope with prison life, is a crucial component of providing a safe environment in which rehabilitation can be achieved. Anticipated outcomes of the Correctional Service Canada's (CSC's) MMTP include a reduction in drug use, and related institutional incidents and disciplinary sanctions during incarceration. In addition, it was anticipated that involvement in the MMTP would facilitate participation in correctional interventions.

What we are doing

The research examines admissions to segregation, disciplinary charges, correctional program participation, and random urinalysis test results among three groups of male offenders - the "continuing MMT" group which consists of offenders who initiated MMT in the community and continued post-incarceration (n=318), the "initiating MMT" group which consists of offenders who initiated MMT while incarcerated (n=827), and the "comparison" group which consists of offenders with a moderate to severe drug problem, who indicated opioids were their most commonly used drug in the 12 months prior to arrest, but who did not participate in the MMTP (n=315). In addition, we examined the outcomes for the initiating MMT group in the time prior to and following MMT initiation (pre- and post-MMT periods), to determine if MMT participation is associated with an improvement in behavior during incarceration.

What we have found so far

Examining the characteristics of the three groups revealed that the initiating MMT group was a much more complex; high risk and high need group compared to the continuing MMT and comparison groups. Due to the complexity of the initiating MMT group in comparison with the other study groups, it was determined that a more appropriate method of examining the impact of MMT on institutional behavior would be to compare the behavior of MMT initiates in the time prior to MMT initiation, compared to the time following MMT initiation, to determine if a change in behavior occurred after an offender began to receive treatment.

The examination of institutional adjustment outcomes for the initiating MMT group in the period before they commenced MMT (the pre-MMT period), as compared to their post MMT participation period revealed positive changes in behavior. For example, there was a decrease in the proportion of positive urinalysis tests (22% vs. 11%), test refusals (22% vs. 16%), and positive opioid tests (8% vs. 1%) in the two years post-MMT participation, compared to the two years pre-MMT involvement. Positive outcomes with respect to correctional program participation were also observed, with the time MMT initiates spent in education and employment programs increasing by 15% and 30%, respectively, in pre- to post-MMT periods. In addition, among offenders who attempted substance abuse and other core programs in both the two years prior to and following MMT initiation, the proportion of completed program attempts increased from 9% in the pre- period to 80% in the post-period for substance abuse programs, and 53% to 80% for other core programs.

What it means

To date, our results point to a decrease in drug use during incarceration, increased compliance with random urinalysis testing as measured by a decrease in test refusals, and positive impacts on correctional program participation and completion for opioid dependent offenders who commence participation in a MMTP while incarcerated.

Prepared by: Mary-Ann MacSwain, Madelon Cheverie, Shanna Farrell MacDonald & Sara Johnson

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