Author Affiliations: Warren Alpert Medical School of Brown University (Dr Clarke) and Department of Obstetrics and Gynecology (Dr Adashi) (email@example.com), Brown University, Providence, Rhode Island.
In Reply: We agree with Drs Fiscella and Rich that addiction is a major problem in prisons and jails and that it has not been adequately addressed. Other major problems in incarcerated populations include undertreated mental health disorders, inadequate education, childhood abuse, poverty, homelessness, and lack of health insurance.1 However, the topic of our Clinical Crossroads and the questions presented to us focused on the issue of pregnancy during incarceration. The patient in question participated in the jail-based addiction treatment, which provided treatment 8 hours a day, 5 days a week, in a therapeutic environment. She was also placed on a low dose of methadone commensurate with the level of opiate use prior to incarceration.
Clarke JG, Adashi EY. Pregnancy, Addiction, and Incarceration—Reply. JAMA. 2011;305(24):2523-2524. doi:10.1001/jama.2011.848