Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings

Abstract

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

Is Tattooing a Risk Factor for Hepatitis C Transmission?: An Updated Systematic Review and Meta-Analysis

“…High risk behaviors as common habits including needle sharing and reusing tattoo needles and equipment were reported 45% among prisoners (45,66). However, a few prisons worldwide provide sterile needles and syringes for inmates (67)(68)(69), which is a measure unlikely to be adopted by most pris-Hepat Mon. 2017; 17(9):e14308.…”

Keynote Address 2018 Southern Maine Harm Reduction Conference

“…This is preferable to opt-in programs that require inmates to request special services to receive naloxone. 69 n Training is provided in a way that refrains from making negative judgments about drug use and focuses instead on the importance of every person's safety and wellbeing even in the context of drug use. 70 n Close contacts of the individual (family, partners, and children) are also trained in naloxone administration and overdose response.…”

“…76 n MAT can be initiated in criminal justice settings. 69 n Individuals have access to all available forms of MAT medication. This choice is essential, as some individuals fare much better (or worse) on one of these drugs than on the other.…”

Assessing factors associated with discharge from opioid agonist therapy due to incarceration in the United States

“…[15][16][17][18] Prior studies suggest that criminalizing drug use results in interruptions in access to services, and increased risk of relapse and overdose upon release into the community. [19][20][21] Several studies point to arrest for possession and distribution of drugs as the primary reason for incarceration of people with substance use disorders which is a major driver of racial and ethnic disparities in criminal justice involvement. [22][23][24] In addition to drug-related offenses, people with OUD are at greater risk of being arrested for property related crimes that are often directly driven by ongoing engagement in substance use.…”