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The Case against Forced Methadone Detox in the US Prisons

机译:美国监狱对美沙酮强迫排毒案

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摘要

Methadone maintenance therapy is a cost-effective, evidence-based treatment for heroin dependence. In the USA, a majority of heroin-dependent offenders are forced to detox from methadone when incarcerated. Recent research published in The Lancet has demonstrated the negative health and economic outcomes associated with such policies (Rich, J. D., McKenzie, M., Larney, S., Wong, J. B., Tran, L., Clarke, J. et al. (2015). Methadone Continuation Versus Forced Withdrawal on Incarceration in a Combined US Prison and Jail: A Randomised, Open Label Trial. The Lancet, 386, 350–359). This novel evidence raises questions as to the justification for current policies of forced detox in American prisons. Opponents of methadone provision in prisons might offer arguments from retributivism, resource allocation and curative effectiveness to justify their position. This article contends that these arguments do not stand up to ethical scrutiny. In light of this, we hold that American policymakers should reform criminal justice policies to allow the initiation and continuation of methadone treatment in correctional settings. This would be consistent with both international recommendations and the example set by a number of other Western countries.
机译:美沙酮维持疗法是一种针对海洛因依赖的经济有效的循证疗法。在美国,大多数海洛因依赖者被监禁时被迫从美沙酮中排毒。 《柳叶刀》杂志上发表的最新研究证明了与此类政策相关的负面健康和经济后果(Rich,JD,McKenzie,M.,Larney,S.,Wong,JB,Tran,L.,Clarke,J.等( 2015)。美沙酮延缓与美国监狱和监狱合并监禁中的强制撤离:随机,开放标签试验(柳叶刀,386,350–359)。这一新颖的证据引起了人们对美国监狱现行强制排毒政策的合理性的质疑。监狱中提供美沙酮的反对者可能会从分配主义,资源分配和治疗效果等方面提出论据,以证明其立场合理。本文认为,这些论点不能经受道德审查。有鉴于此,我们认为美国决策者应改革刑事司法政策,以允许在惩戒环境中开始和继续使用美沙酮治疗。这将与国际建议和许多其他西方国家树立的榜样保持一致。

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