Factors associated with opioid-involved overdose among previously incarcerated people in the U.S.: A community engaged narrative review

Flam-Ross, Juliet M.; Lown, Josh; Patil, Prasad; White, Laura F.; Wang, Jianbo; Perry, Ashley; Bailer, Dennis; McKenzie, Michelle; Thigpen, Anthony; Newman, Roxxanne; Lincoln, Meko; McKinney, T; Bernson, Dana; Barocas, Joshua A.

doi:10.1016/j.drugpo.2021.103534

Cited by 10 publications

(5 citation statements)

References 42 publications

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“…Overdose risk caused by liberation to environments that trigger drug use may be somewhat ameliorated by provision of take-home naloxone, but research has shown people in prison may not be receptive to training and carriage of naloxone, and motivation to carry it is complicated by desires to remain abstinent [ 126 , 127 ]. Beyond individual factors, useful conceptual frameworks have been posited to frame the multilevel nature of the determinants involved in overdose risk upon liberation, which suggest researchers shift the lens through which this issue framed from the individual to the socio-structural [ 128 , 129 ]. Our findings highlight the harms conferred by structural control mechanisms which reinforce criminalisation of drug use and compound inequalities experienced by people who use drugs in health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis

Byrne,

Sani,

Thain

et al. 2024

Harm Reduct J

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Background and aims Psychological and social status, and environmental context, may mediate the likelihood of experiencing overdose subsequent to illicit drug use. The aim of this systematic review was to identify and synthesise psychosocial factors associated with overdose among people who use drugs. Methods This review was registered on Prospero (CRD42021242495). Systematic record searches were undertaken in databases of peer-reviewed literature (Medline, Embase, PsycINFO, and Cinahl) and grey literature sources (Google Scholar) for work published up to and including 14 February 2023. Reference lists of selected full-text papers were searched for additional records. Studies were eligible if they included people who use drugs with a focus on relationships between psychosocial factors and overdose subsequent to illicit drug use. Results were tabulated and narratively synthesised. Results Twenty-six studies were included in the review, with 150,625 participants: of those 3,383–4072 (3%) experienced overdose. Twenty-one (81%) studies were conducted in North America and 23 (89%) reported polydrug use. Psychosocial factors associated with risk of overdose (n = 103) were identified and thematically organised into ten groups. These were: income; housing instability; incarceration; traumatic experiences; overdose risk perception and past experience; healthcare experiences; perception of own drug use and injecting skills; injecting setting; conditions with physical environment; and social network traits. Conclusions Global rates of overdose continue to increase, and many guidelines recommend psychosocial interventions for dependent drug use. The factors identified here provide useful targets for practitioners to focus on at the individual level, but many identified will require wider policy changes to affect positive change. Future research should seek to develop and trial interventions targeting factors identified, whilst advocacy for key policy reforms to reduce harm must continue.

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Section: Discussionmentioning

confidence: 99%

Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis

Byrne,

Sani,

Thain

et al. 2024

Harm Reduct J

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“…Independent variables were determined a priori , based on a literature review of factors associated with opioid consumption patterns among PWUD during the COVID-19 pandemic. These included age ( Friesen et al , 2021 ), ethnicity ( Friesen et al , 2021 ), income ( Ali et al , 2021 ; Rosic et al , 2021 ), household density ( Friesen et al , 2021 ; Rosic et al , 2021 ) and history of overdose ( Flam-Ross et al , 2022 ). Unstable housing was also associated with changes in opioid consumption ( Friesen et al , 2021 ; Rosic et al , 2021 ) but was excluded because of its correlation with income.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with changes in illicit opioid use during the COVID-19 pandemic among incarcerated people who use drugs in Quebec, Canada

Park

Linthwaite

Dussault

et al. 2022

IJPH

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Purpose People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic. Design/methodology/approach The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated. Findings A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively. Originality/value The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

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“…Community-engaged research (CEnR) that involves people with living or lived experience can rebalance power dynamics by centering on and elevating voices of communities that are often marginalized, informing the design of interventions tailored to specific communities (Swierad & Huang, 2021 ), and co-creating a knowledge base to have substantial social impacts on the relationship between carceral involvement, substance use, and overdose (Crawford-Browne & Kaminer, 2012 ; Jull et al, 2017 ). For example, one study using a CEnR approach found several previously unidentified risk factors (e.g., knowledge of an imminent reincarceration) and several protective factors (e.g., having children, presence of a caseworker when accessing services, positive relationship with a probation officers) for overdose in previously incarcerated individuals (Flam-Ross et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Identifying structural risk factors for overdose following incarceration: a concept mapping study

Nall,

Jurecka,

Ammons

et al. 2024

Health Justice

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Background Currently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities. People with lived experiences in the criminal legal system and with substance use disorder hold unique perspectives and must be involved in the research process. Objective To identify perceived factors that impact overdose following release from incarceration among people with direct criminal legal involvement and experience with substance use. Methods Within a community-engaged approach to research, we used concept mapping to center the perspectives of people with personal experience with the carceral system. The following prompt guided our study: “What do you think are some of the main things that make people who have been in jail or prison more and less likely to overdose?” Individuals participated in three rounds of focus groups, which included brainstorming, sorting and rating, and community interpretation. We used the Concept Systems Inc. platform groupwisdom for our analyses and constructed cluster maps. Results Eight individuals (ages 33 to 53) from four states participated. The brainstorming process resulted in 83 unique factors that impact overdose. The concept mapping process resulted in five clusters: (1) Community-Based Prevention, (2) Drug Use and Incarceration, (3) Resources for Treatment for Substance Use, (4) Carceral Factors, and (5) Stigma and Structural Barriers. Conclusions Our study provides critical insight into community-identified factors associated with overdose following incarceration. These factors should be accounted for during resource planning and decision-making.

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Factors associated with opioid-involved overdose among previously incarcerated people in the U.S.: A community engaged narrative review

Cited by 10 publications

References 42 publications

Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis

Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis

Factors associated with changes in illicit opioid use during the COVID-19 pandemic among incarcerated people who use drugs in Quebec, Canada

Identifying structural risk factors for overdose following incarceration: a concept mapping study

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