Pharmacological treatment of substance abuse in correctional facilities: Prospects and barriers to expanding access to evidence-based therapy

The aim of this chapter is to review a much-neglected area of correctional health care: the pharmacological treatment of substance abuse. The particular focus of this review will be on the evidence, prospects, and barriers to implementation among the five federally approved and currently available medications for the pharmacological treatment of substance abuse: methadone, naltrexone, buprenorphine, disulfiram, and acamprosate. We will discuss each of these, as well as provide additional insights into the prospects for treatment of cocaine and methamphetamine abuse. These two additional conditions are also serious public health concerns and are highly prevalent among incarcerated populations (Cartier, Farabee, & Prendergast, 2006; Miura, Fujiki, Shibata, & Ishikawa, 2006). It is likely that over the next decades we will see the advent of several new drugs to adequately treat these chemical dependencies, and when that time comes, it will be important to build from a successful foundation of correctional experiences with other pharmacotherapies of substance abuse.