Drug- and Alcohol-Associated Deaths in U.S. Jails

Fiscella, Kevin; Noonan, Margaret; Leonard, Susan Hautaniemi; Farah, Subrina; Sanders, Mechelle; Wakeman, Sarah E.; Savolainen, Jukka

doi:10.1177/1078345820917356

Cited by 15 publications

(8 citation statements)

References 24 publications

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“…Buprenorphine also has the advantage of exhibiting less lethality than full agonists due to ceiling effects on respiratory depression (Walsh, Preston, Stitzer, Cone, & Bigelow, 1994;Yokell et al, 2011). A recent analysis of drug-and alcohol-associated deaths in U.S. jails found no deaths associated with buprenorphine (Fiscella et al, 2020). However, as a partial mu-receptor agonist, buprenorphine can be reinforcing (Yokell et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…At a population level, opioid misuse and OUD are strongly associated with criminal justice system involvement (Winkelman, Chang, & Binswanger, 2018). Deaths from opioids and other substances have been reported during incarceration (Fiscella et al, 2020). Upon release from incarceration, people with OUD are especially prone to relapse and face elevated risk of overdose death due to diminished tolerance (Binswanger, Blatchford, Mueller, & Stern, 2013;Joudrey et al, 2019;Krinsky, Lathrop, Brown, & Nolte, 2009;Merrall et al, 2010;Seaman, Brettle, & Gore, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Use of non–prescribed buprenorphine in the criminal justice system: Perspectives of individuals recently released from incarceration

Gryczynski

Lee

Dušek

et al. 2021

Journal of Substance Abuse Treatment

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Buprenorphine, an effective treatment for opioid use disorder (OUD), remains underutilized in many U.S. jails and prisons. However, use of non-prescribed (i.e., diverted) buprenorphine has been reported in these settings. The current study examined non-prescribed buprenorphine use experiences in correctional and community contexts. The study conducted face-to-face interviews with 300 adults with OUD/opioid misuse and recent incarceration, recruited in Baltimore, MD, and New York, NY (n = 150 each). Illicit/non-prescribed opioid use during incarceration was reported by 63% of participants; 39% reported non-prescribed buprenorphine. Non--prescribed buprenorphine was considered the most widely available opioid in jails/prisons in both states (81% reported "very" or "somewhat" easy to get). The average price of non-prescribed buprenorphine in jail/prison was ~10× higher than in the community (p < 0.001). Participants were more likely to endorse getting high/ mood alteration as reasons for using non-prescribed buprenorphine during incarceration, but tended to ascribe therapeutic motives to use in the community (e.g., self-treatment; p < 0.001). Multivariable logistic regression analyses showed that different individual-level characteristics were associated with history of non-prescribed buprenorphine use during incarceration and in the community. Use of non-prescribed buprenorphine during incarceration was associated with younger age (p = 0.006) and longer incarceration history (p < 0.001), while use of non-prescribed buprenorphine in the community was associated with MD recruitment site (p = 0.001), not being married (p < 0.001), prior buprenorphine treatment experience (p < 0.001), and housing situation (p = 0.01). These findings suggest that different dynamics and demand characteristics underlie the use of non--prescribed buprenorphine in community and incarceration contexts, with implications for efforts to expand OUD treatment in correctional settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of non–prescribed buprenorphine in the criminal justice system: Perspectives of individuals recently released from incarceration

Gryczynski

Lee

Dušek

et al. 2021

Journal of Substance Abuse Treatment

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“…A person who has been arrested shortly after ingesting methamphetamine or consuming alcohol may require immediate medical attention for behavioral outbursts or cardiac conditions (Isoardi et al, 2019). Methamphetamine and alcohol have recently played a substantial role among deaths in correctional facilities, making it imperative to identify and address these needs as soon as possible following entry to the detention center (Fiscella et al, 2020; Jones et al, 2014; Lewis et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…SUD is one of the most prominent conditions observed among people confined in jails, and national estimates indicate nearly two thirds (63%) of those who were sentenced met the criteria for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of abuse or dependence (Bronson et al, 2017). Drugs and alcohol have also been identified as the third leading cause of death in jails, a trend which has been rising steadily (Carson, 2021; Fiscella et al, 2020). However, not all substances are equally likely to contribute to jail admission or death in custody.…”

Section: Sud In Jail Populationsmentioning

confidence: 99%

Substance use disorder and rural detention center readmission: Results from a 3-year prospective cohort study.

Kopak¹,

Raggio²

2023

Journal of Rural Mental Health

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Despite the steady increase in drug-related overdoses and deaths in custody recorded in jails, limited research has focused on substance use disorder (SUD) in rural county detention facilities. The first goal of this study was to provide an accurate assessment of the prevalence of SUDs in a rural jail and the second was to determine how these specific conditions were associated with readmission over a 3-year period. Comprehensive interviews consistent with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition SUD diagnoses were conducted with a cohort of 283 participants admitted to a rural detention center in a southern Appalachian County. Official records were obtained from the facility's database to determine the number of admissions and the length of detention. After identifying bivariate associations between specific SUDs and readmission, multivariate models were estimated to further assess these relationships while accounting for demographic background factors. Alcohol use disorder (71.0%) was the most prevalent condition, followed by methamphetamine (48.8%), and cannabis (36.4%). Those who endorsed criteria consistent with more severe designations of methamphetamine use disorder (MUD) had higher rates of readmission (incidence rate ratio [IRR] = 1.11, p = .031) compared with those who did not endorse similar criteria. A MUD was also associated with a significantly higher rate of days detained (IRR = 1.17, p = .004), demonstrating a longer period of detention for those who endorsed these criteria. Identifying specific SUDs in rural jail populations is an important first step toward a long-term strategy to reduce lengths of confinement and the likelihood of repeat admissions. Public Health Significance StatementThe majority of people admitted to rural jails present indications of substance use disorder, but comprehensive assessments are not available in many facilities. Alcohol and methamphetamine are among the most prevalent in some areas, and the most severe cases are associated with an increased likelihood of readmission. Rural jails must facilitate connections to care in order to reduce lengths of detention and the risk of repeated admissions.

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“…Despite the expansion of access to MOUDs in communities across the Unites States, there are often a number of concerns that arise as barriers specific to jails. Barriers include concerns regarding the potential diversion of medications, overdoses, and withdrawal-related deaths ( Fiscella et al, 2020 ; White et al, 2016 ), as well as service delivery shortcomings, since the administration of MOUDs often requires additional staff effort, special training (e.g., an X waiver for providers prescribing buprenorphine), and systems of monitoring administration ( NSA & NCCHC, 2018 ). This may be compounded by the preference among administrators for non-MOUD interventions and numerous state and federal regulations regarding opioid agonist treatment ( Friedmann et al, 2012 ; Moore et al, 2018 ; Zaller et al, 2013 ).…”

mentioning

confidence: 99%

Development and use of a checklist for the implementation of medication for opioid use disorder in jails

Ludwig

Monico

Blue

et al. 2022

Implementation Research and Practice

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Background: In light of short lengths of stay and proximity to communities of release, jails are well-positioned to intervene in opioid use disorder (OUD). However, a number of barriers have resulted in a slow and limited implementation. Methods: This paper describes the development and testing of a Medication for Opioid Use Disorder (MOUD) Implementation Checklist developed as part of a Building Bridges project, a two-year planning grant which supported 16 US jail systems as they prepared to implement or expand MOUD services. Results: Although initially developed to track changes within sites participating in the initiative, participants noted its utility for identifying evidence-based benchmarks through which the successful implementation of MOUDs could be tracked by correctional administrators. Conclusions: The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports. Plain Language Summary: People incarcerated in jails are more likely to have opioid use disorder than the general population. Despite this, jails in the United States (U.S.) often offer limited or no access to Medication for Opioid Use Disorder (MOUD). The Building Bridges project was designed to address this gap in 16 U.S. jail systems as they prepared to implement or expand MOUD services. This article addresses the use of a MOUD checklist that was initially designed to help the jails track changes toward evidence-based benchmarks. The findings suggest that this checklist can both help guide and illustrate progress toward vital changes facilitated through established processes and supports.

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Drug- and Alcohol-Associated Deaths in U.S. Jails

Cited by 15 publications

References 24 publications

Use of non–prescribed buprenorphine in the criminal justice system: Perspectives of individuals recently released from incarceration

Use of non–prescribed buprenorphine in the criminal justice system: Perspectives of individuals recently released from incarceration

Substance use disorder and rural detention center readmission: Results from a 3-year prospective cohort study.

Development and use of a checklist for the implementation of medication for opioid use disorder in jails

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