Having been in prisons in 2 nations, while addicted, I have quite a bit of subjective expereince in this matter.
Rikers is not the only US facility that has methadone. It is in Seattle, Mnmouth Co. Correctional in NJ, and many other places. Back in the 80s the claim would have been true though. Back then the most you could get was Clonidine and a Tylenol without Codeine of course.
Rikers by the way is no picnic. When admitted (and I have been a few times) you must wait to see Medical for up to a day and ahalf. Then , after telling them you are in a program, you must wait for verification which always waits until normal buisiness hours. Even if your clinic provides 24 hour verificationn, Rikers will not even try until buisiness hours.
Then, you will be given 10 mgs. less than your street dose and that decreases 10 every 3 days until 30, then 5 every day. At 0 you will get Dalmane for a few days to help you sleep at night.
You can get in KEEP which is Maintenance if you have a misdemeanour or less than a year time for a felony. That takes time and patience though in order to even gain your interview. Remember, there are almost 18,000 people on Rikers and the dope house, C95 has a good 4000. It is so big that the COs use golfcartstomove from place toplace.
If you are not in a program, good luck. If you have very fresh tracks you can often get 20 mgs. which will decrease 5 every 3 days. No fresh tracks, no methadone, EVER.
I will say though, if you have to be in any jail, methadone is the way to go. Every evening after supper they call meds out , you line up with your id badge on your collar, and march down to medical and get your dose. You should see the projects, the dorms, after dosing...Like a zoo.
There are often mistakes though. I received a 20 thousand US settlement because I was incarcerated 3 days past my due date and as a result was not dosed for more than 4 days. I was on 190 so it was not fun.
As for dying from w/d...I am in methadone w/d right now, cold turkey. If you have another medical problem you can die but not from w/d itself. It still is nopicnic though.