A Rutgers University study highlights the importance of strengthening prison reentry programs to address the U.S. opioid crisis. Newly incarcerated inmates are at higher risk for opioid overdose, while those who take psychotropic drugs or have a history of injecting drugs are more likely to seek post-release treatment, the study found.
A Rutgers University study shows that strengthening prison reentry programs could reduce opioid overdose deaths in the United States. As opioid overdose deaths surge in the United States, many communities are urgently seeking effective solutions. A new study led by Rutgers University identifies strengthening prison reentry programs for high-risk drug users as one of the most promising interventions.
"For addicts who have served several years in prison, the period of reentry can be confusing and disorienting," said Grant Victor, an assistant professor at the Rutgers School of Social Work and lead author of the study published in the Journal of Offender Rehabilitation.
"Closing the post-release health care gap, especially for those with mental and behavioral health issues, may increase their willingness to receive treatment for opioid use," Victor said.
Incarceration is a significant risk factor for opioid-related death. A 2013 study found that people recently released from prison were about 129 times more likely to suffer a fatal drug overdose than the general population. Another study led by Victor found that 20 percent of opioid-related overdose deaths in a community involved people released from prison within three years.
To investigate risk factors and potential solutions, Victor and colleagues at Northern Arizona University and Wayne State University applied machine learning to data from a Midwestern reentry program for incarcerated people with co-occurring opioid use and mental illness.
"We want to know two things," Victor said. "First, what factors increase the likelihood that someone will take opioids to treat a mental disorder within a month of being released from prison? Second, within this already vulnerable group, is there a subgroup that is at greatest risk for opioid-related death after release from prison?"
Researchers found that people who were prescribed psychiatric medications in the months before release from prison were most likely to begin treatment for opioid use disorder. Participants' history of injection drug use was another trigger: Those who reported using injection drugs were more likely to seek treatment after release than those who did not.
The findings suggest safe syringe services should be expanded in prisons. These services not only increase engagement in opioid use treatment but also effectively reduce the spread of infectious diseases such as HIV and hepatitis.
"Bringing the most vulnerable people into the health care ecosystem upon release appears to be beneficial for those at risk for opioid overdose. We found that those receiving psychiatric care were more likely to participate in an opioid treatment program," Victor said.
Few studies describe the positive relationship between psychopharmacological treatment and treatment of opioid use in reentry populations. One reason is that reintegration programs using opioids are rare in the United States.
"Most prison systems do not have these types of reintegration programs," he said. "But our findings support previous research that shows if you have contact with this population while incarcerated, it improves post-release outcomes."
In light of these findings, state and federal prison systems should consider improving their "cascade of care" for opioid use, such as implementing standardized screening tools to identify at-risk populations in prison and providing them with robust and accessible services upon release.