I read with concern your recent article regarding the Trump administration’s promotion of Vivitrol, or naltrexone (“Trump opioid plan may lift Alkermes,’’ Business, March 27). Meanwhile, in Massachusetts, patients doing well on their long-term methadone or buprenorphine are uncomfortably forced off of their treatments while incarcerated but continued on medications for other chronic diseases (“Prison opioid rules get scrutiny,’’ Page A1, March 29).

Forced detoxification from opioids among incarcerated patients has been shown to be harmful, making them less likely to engage in evidence-based medication treatment upon release. This practice is also inhumane. Loss of tolerance to opioids, through forced detoxification, is one of the reasons overdose deaths are so high among recently released patients.

Detoxification is necessary for initiating naltrexone, but not for starting (or continuing) methadone or buprenorphine. Methadone and buprenorphine have been shown to improve morbidity and mortality, while naltrexone has not and is thus not considered a first-line treatment by many addiction experts. There is emerging evidence that naltrexone is associated with overdose within two months of treatment. Promoting naltrexone, especially in a vulnerable population, is a costly mistake, measured not just in dollars but in patients’ lives.

Dr. Zoe Weinstein

Boston

The writer is an assistant professor of medicine at Boston University School of Medicine and director of the Addiction Consult Service at Boston Medical Center.