Characteristics of women participants in the methadone maintenance treatment program: July 2012

Recent research on male participants of CSC's Methadone Maintenance Treatment Program (MMTP) revealed a very high risk, high need, complex group of offenders (Johnson, Farrell MacDonald, & Cheverie, 2012). An understanding of the characteristics of women MMTP participants will assist in enhancing treatment services for women.

The research compares characteristics of 209 women offenders who initiated CSC's MMTP between 2003 and 2008, with a group who were incarcerated during the same time period, but who did not participate in the MMTP (n = 1,879). In addition, we are examining the self reported histories of substance abuse, related high risk behaviours, trauma, and treatment for mental health issues among MMTP participants.

Approximately one in ten women participated in the MMTP. Compared to non-participants, MMT participants were rated as being higher risk, and more likely to have greater criminogenic needs in the areas of employment, marital/family, associates, and substance abuse, with a lower reintegration potential and motivation level to change their behaviour. Furthermore, MMT participants have more extensive criminal histories, with a greater number of federal sentences served, and a greater number of offences for which they were serving their current sentence. MMT participants were more likely to be serving time for acquisitive crimes such as theft, break and enter, and fraud, and less likely to be serving time for drug related offences.

Additional analyses of female MMTP participants revealed that most (68%) identify pharmaceutical opioids as their opioid of choice (rather than heroin, or a combination of heroin and pharmaceutical opioids). However, regional variation was observed in this respect, with heroin use being more prevalent in the Quebec and Pacific regions. Just under two thirds reported a lifetime history of problematic drug use in addition to their opioid use, with cocaine being reported as the most commonly used drug.

A very high number of women in the MMT group indicated a lifetime history of high risk behaviour related to their drug use, including injection drug use (97%) and needle sharing (74%). Just over one third reported using opioids while incarcerated prior to MMT participation, with 62% of those who used opioids reporting injection drug use while incarcerated, and 86% of those who injected reporting needle sharing.

A striking finding is the high proportion of women reporting a lifetime history of various mental health issues and trauma, specifically treatment for anxiety (62%) and depression (63%), a history of suicide attempts (57%) and self injury (39%), and mental (74%), physical (81%), and sexual (67%) abuse.

Consistent with results of research by Johnson and colleagues (in press) on male MMTP participants, CSC's female MMTP participants are a very high risk, high need group of offenders who present with multiple issues which may need to be considered while treating their opioid dependence. In particular, the high prevalence of mental health issues and trauma in this population, given the well documented relationship between substance use, trauma, and mental illness, should be considered. Further research is under way to examine the impact of CSC's MMTP on the post release outcomes for women participants.

References:
Johnson, S., Farrell MacDonald, S., & Cheverie, M. (2012). Characteristics of Participants in the Methadone Maintenance Treatment (MMT) Program. Research Report R253. Ottawa, ON: Correctional Service Canada.

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