Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Trail of Continues Methadone Maintenance Versus Detoxification in Jail
Brief Summary: Methadone maintenance treatment (MMT) has been shown to be effective in reducing drug use, criminal activity and recidivism. Given this effectiveness, maintaining individuals who are enrolled in community MMT when committed to the Department of Corrections for short term incarceration would improve post release outcomes. However, this is rarely practiced in the United States. Current practice at the Rhode Island Department of Corrections is to detox inmates on methadone within 30 days of being incarcerated. More than 75% of these individuals are incarcerated for less than six months. The period immediately after release from incarceration is a particularly high-risk time for HIV and other problems including drug relapse and overdose.

The investigators hypothesize that inmates who are incarcerated for 6 months or less will have better outcomes and cost the state less money if they are maintained on their methadone dose and relinked to their community clinic at release, than the current practice of detoxification.


Options:
A: Inclusion Criteria:

* The sample for the study will be drawn from an offender population who are within 2-3 weeks of their release from MCJ or CRDF in Los Angeles County. In addition, subjects must be:

  * At least 18 years of age
  * English or Spanish speaking
  * Not subject to extended jail or prison sentence
  * Able to provide informed consent to participate in the study

Exclusion Criteria:

* Study exclusion criteria:

  * Inability to provide informed consent to study participation because of cognitive impairment.
  * Inability to communicate in either English or Spanish
  * Refusal to complete Locator form for follow-up.
B: Inclusion Criteria:

* qualify for a DSM-IV lifetime diagnosis of cocaine dependence and cocaine use in 6 months prior to treatment;
* initial engagement in IOP, as indicated by attendance at 4 or more sessions in the first two weeks of treatment;
* 18 to 75 years of age;
* willingness to be randomized and participate in research.
* metropolitan area residents;
* able to provide the name, verified telephone number, and address of at least one contact who can provide locator information on the patient during follow-up.

Exclusion Criteria:

* current psychotic disorder or evidence of dementia severe enough to prevent participation in outpatient treatment;
* acute medical problem requiring immediate inpatient treatment;
* current participation in methadone or other forms of DA treatment, other than IOP
C: Inclusion Criteria:

(a) Substance abuse or dependence disorder requiring outpatient treatment, and (b)after consulting with his or her attorney, the youth and family voluntarily agrees to enter juvenile drug court.

Exclusion Criteria:

(a) Their current offense is the sale of drugs, a gun offense, a violent offense, or sexual battery,(b) their current offense is likely to merit commitment to a secure or locked juvenile justice facility or (c) they have severe mental illness or retardation according to their intake MJDC evaluation.
D: Inclusion Criteria:

* currently incarcerated at the RI Department of Corrections
* enrolled in a Rhode Island methadone treatment program at the time of incarceration
* currently maintained at the pre-incarceration methadone dosage level
* estimated total incarceration time of \< 6 months and \> 1 week
* willing to be randomized and to conduct follow-up interviews for 12 months
* English or Spanish-speaking
* able to give informed consent
* age 18 years or older
* willing to remain on MMT and continue MMT after release.

Exclusion Criteria:

* pregnancy (pregnant women are maintained on pre-incarceration levels of methadone throughout their pregnancy for their health and the health of the fetus by the RI DOC, so are NOT eligible to be randomized to Arm 2)
* not fulfilling all of the inclusion criteria.

Answer: D