Date of Award

4-24-2025

Document Type

Scholarly Project

First Advisor

Dr. Meghan Mitchell

Abstract

Methadone Maintenance Treatment (MMT) has emerged as a harm-reduction strategy for addressing opioid use disorder (OUD) among justice-involved juveniles. Despite its growing implementation, there remains limited consensus regarding its effectiveness in reducing recidivism, its ethical and legal implications, and the systemic barriers surrounding its administration. This study employed a systematic literature review (SLR) to examine the therapeutic, ethical, and criminological dimensions of MMT in juvenile justice populations. The review followed PRISMA 2020 guidelines and synthesized 15 peer-reviewed empirical studies published between 2010 and 2023. Data were sourced from four major electronic databases PubMed, PsycINFO, Scopus, and Web of Science using targeted search terms related to methadone, juvenile justice, opioid use, recidivism, and youth treatment outcomes.

Thematic analysis of the included studies revealed that 40% (6 studies) reported a statistically significant reduction in recidivism among juveniles who received MMT post-release. These studies measured outcomes such as Adherence, Relapse and Recidivism. However, 60% of the studies either showed no significant impact on recidivism or attributed inconsistent outcomes to the lack of integrated support services. This suggests that MMT alone may not be sufficient to deter reoffending unless embedded within a comprehensive rehabilitative framework that includes trauma-informed care and wraparound services.

Implementation challenges were recurrent across the studies. Approximately 53% (8 studies) identified discontinuity of care during the transition from incarceration to community-based treatment as a critical obstacle. Furthermore, 47% (7 studies) reported ethical and legal challenges, particularly those related to informed consent, minor autonomy, and the role of guardianship in treatment initiation. Additionally, stigma both institutional and familial was cited in 60% (9 studies) as a deterrent to sustained engagement with MMT among adolescents.

The findings underscore that while MMT can stabilize opioid use and support treatment adherence, its effectiveness in reducing criminal recidivism is conditional upon systemic factors. The review highlights the need for policy frameworks that ensure ethical safeguards, improve treatment continuity, and mitigate stigma. Future research should explore integrated models that combine MMT with psychosocial support and youth-centered rehabilitative services. Doing so may enhance not only treatment outcomes but also long-term legal and social reintegration prospects for justice-involved youth with OUD.

Recommended Citation

Bortieh, Joshua, "Juvenile Treatment: A Systematic Review of Methadone on Juveniles After Incarceration" (2025). Criminal Justice Scholarly Projects. 1.
https://commons.und.edu/cj-sp/1

Bortieh - Presentation.pdf (5474 kB)
Presentation