The Importance of Methadone in Jail: A Lifeline for People in Withdrawal

For individuals struggling with opioid addiction, incarceration does not pause the physiological grip of dependence. When a person who regularly uses opioids is suddenly cut off, their body goes into withdrawal.  This can result in a painful, debilitating process that can have severe, even life-threatening consequences. One of the most effective treatments for opioid withdrawal and long-term recovery is methadone, a medication that has been proven to reduce withdrawal symptoms and curb cravings. However, access to methadone in jails remains inconsistent, leaving many incarcerated individuals to suffer needlessly.  Regardless, county jails have a constitutional obligation to provide medical care to and protect inmates.

What Happens During Opioid Withdrawal?

When someone dependent on opioids like heroin or fentanyl is suddenly deprived of the drug, his or her body reacts violently. Withdrawal symptoms can begin within hours and may last for days or even weeks. Symptoms include:

• Severe body aches and muscle cramps
• Nausea, vomiting, and diarrhea
• Sweating and chills
• Intense anxiety and agitation
• Insomnia and restlessness
• Rapid heart rate and high blood pressure

Beyond the sheer misery of withdrawal, there are serious health risks. Dehydration from persistent vomiting and diarrhea can lead to electrolyte imbalances and heart complications. In some cases, withdrawal can trigger fatal cardiac events or complications from pre-existing conditions. Additionally, the psychological distress of withdrawal can drive desperate behaviors, including self-harm and suicide.

Why Methadone Matters in Jails

Methadone is a long-acting opioid agonist that helps stabilize individuals by preventing severe withdrawal symptoms without producing a high. It has been used for decades as a gold-standard treatment for opioid use disorder (OUD). Administering methadone in jails offers numerous benefits:

1. Reduces Suffering and Prevents Medical Emergencies

Providing methadone allows jail detainees to detox safely and gradually, minimizing withdrawal symptoms and reducing the risk of medical crises.

2. Prevents Overdose Post-Release

People who go through forced withdrawal in jail develop a drastically lower opioid tolerance. If they relapse upon release (which is common when addiction goes untreated), they are at extreme risk of overdose, as their usual dose may now be fatal. Studies show that providing methadone in jail significantly lowers overdose death rates after release.

3. Decreases Violent Incidents and Behavioral Issues

Withdrawal can make people extremely agitated, increasing the likelihood of fights, self-harm, or disruptive behavior. Treating withdrawal with methadone helps stabilize mood and reduces conflict, making jails safer for both inmates and staff.

4. Supports Long-Term Recovery

Methadone is not just a withdrawal aid.  It is also used for sustained recovery. People who receive methadone in jail are more likely to continue treatment upon release, reducing their risk of relapse and recidivism.  This can help society as a whole.

The Consequences of Denying Methadone

When jails refuse to provide methadone, the consequences can be devastating:

• Increased overdoses: Many people leave jail and immediately relapse, often overdosing due to reduced tolerance.
• Higher suicide rates: The agony of withdrawal and the despair of addiction can push some individuals to take their own lives.
• Medical emergencies: Dehydration, seizures, and heart complications from withdrawal can lead to hospitalization or death.  Our jail death law firm has handled a number of cases in which a person died from a seizure, ands seizures can arise as a result of various causes.
• Greater recidivism: Without proper treatment, people are more likely to return to drug use, increasing their chances of reoffending and returning to jail.   This results in an increased societal cost.

The Need for Policy Change

Despite the overwhelming evidence supporting methadone treatment in jails, many facilities still do not offer it. This is often due to outdated policies, stigma against medication-assisted treatment (MAT), or logistical barriers. However, the tide is shifting. Some states and local jurisdictions have begun implementing MAT programs in jails, recognizing that treating addiction as a medical condition rather than a moral failing leads to better outcomes for individuals and society as a whole.

Written By: Dean Malone

Dean Malone

Dean Malone is the founder of Law Offices of Dean Malone, P.C., a jail neglect civil rights law firm. Mr. Malone earned his bachelor's degree at the University of Texas at Dallas, graduating summa cum laude with a 4.0 GPA, and from Baylor University School of Law with a general civil litigation concentration. Mr. Malone served in several staff positions for the Baylor Law Review, including executive editor. Mr. Malone is an experienced trial lawyer, trying a number of cases to jury verdict and also handling arbitrations through final hearing. He heads the jail neglect section of his law firm, in which lawyers litigate cases involving serious injury and death resulting from jail neglect and abuse. Lawyers frequently refer cases to Mr. Malone due to his focus on this very complicated civil rights practice area.