COVID-19 and mass incarceration: a call for urgent actionAs of September 23, 2020, the USA had both the highest number of COVID-19 cases and the largest incarcerated population in the world. Approximately 2•3 million people are currently incarcerated in prisons and jails in the USA. More than 6•5 million individuals are under daily correctional supervision, which includes probation and parole, representing 2•6% of the entire US adult population.Due to systemic racism, Black people have been disproportionately affected by mass incarceration and COVID-19. Nearly one-third of Black men will face imprisonment during their lifetime, 1 and Black communities have a markedly higher burden of COVID-19 cases and mortality than White populations. 2 Considering the inextricable link between the health of Black communities and the US criminal legal system, jails and prisons are uniquely positioned to advance health equity and community health, particularly during the ongoing response to the COVID-19 pandemic.Concurrently, the discrimination and criminalisation of additional stigmatised groups-including people who are poor, who use drugs, and those who have mental health disorders-have deepened and reinforced health disparities.Calls for deliberate anti-racist action have been made across the nation following the murders of George Floyd, Breonna Taylor, Jacob Blake, and countless others at the hands of police. Police brutality is culturally salient and demands our attention, however, it only represents a small proportion of the damage inflicted by the criminal legal system on Black communities. Stark racial differences in the relative number of police stops, arrests, plea deals, guilty verdicts, and time served are among the most obvious and profound examples of systemic racism in the USA today. Correspondingly, social justice movements to abolish these inequities will be ineffectual without close attention to the racial politics of imprisonment.Jails and prisons have been severely affected by the COVID-19 pandemic. In the USA, more than 40 of the 50 largest clustered outbreaks in the country have occurred in jails and prisons. 3 Compared with the general population, the number of COVID-19 cases is 5•5 times higher among people who are incarcerated. 4 However, racial disparities in testing and case rates remain

No abstract

No abstract

BackgroundAlthough the burden of opioid use disorder is disproportionately high among persons who are incarcerated, medications for opioid use disorder are often unavailable in correctional settings. The Rhode Island Department of Corrections provides all 3 classes of medications for opioid use disorder to clinically eligible persons who are incarcerated. Despite a decrease in fatal overdoses among persons with recent criminal legal system involvement since the program's implementation, barriers to continued engagement in treatment after release from incarceration still exist.MethodsWe conducted 40 semistructured, qualitative interviews with people who were incarcerated and enrolled in the comprehensive medications for opioid use disorder program at the Rhode Island Department of Corrections. Analysis applied a general, inductive approach using NVivo 12.ResultsParticipants discussed barriers to treatment engagement before incarceration, as well as anticipated barriers to medications to treat opioid use disorder continuation after release from incarceration. Structural factors including housing, health insurance, transportation, and the treatment program structure, as well as social factors such as social support networks were perceived to influence retention in medications to treat opioid use disorder post-release.ConclusionOur findings suggest that people with opioid use disorder who are incarcerated encounter unique challenges upon community reentry. Addressing structural factors that pose barriers to post-release engagement is essential to sustaining retention. We recommend utilization of peer recovery specialists to alleviate some of the stress of navigating the structural barriers identified by participants.