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June 22 2011

Pregnancy, Addiction, and Incarceration

Author Affiliations

Author Affiliations: Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York (Dr Fiscella) (; and Center for Prisoner Health and Human Rights, Brown University Medical School, Providence, Rhode Island (Dr Rich).

JAMA. 2011;305(24):2523-2524. doi:10.1001/jama.2011.847

To the Editor: In the discussion by Drs Clarke and Adashi of perinatal care for incarcerated pregnant women, they included a few paragraphs on addiction, and the patient in the case presented had heroin and tobacco addiction.1 However, the problem of addiction in inmates, pregnant or not, deserves more emphasis.

The number of inmates incarcerated nationally for drug-related offenses has increased 12-fold, from 41 000 in 1980 to nearly a half million currently,2 at an annual cost of roughly $22 000 per inmate.3 Half of all jail and prison inmates meet diagnostic criteria for drug abuse or dependence.3 Jails and prisons therefore represent potential critical entry points into drug treatment.

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