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

• Pages: 25-31
• DOI: https://doi.org/10.1108/IJPH-08-2016-0039
• Published date: 13 March 2017
• Date: 13 March 2017
• Author: Lauren Brinkley-Rubinstein,David H. Cloud,Chelsea Davis,Nickolas Zaller,Ayesha Delany-Brumsey,Leah Pope,Sarah Martino,Benjamin Bouvier,Josiah Rich
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Addressing excess risk of overdose

among recently incarcerated people

in the USA: harm reduction interventions

in correctional settings

Lauren Brinkley-Rubinstein, David H. Cloud, Chelsea Davis, Nickolas Zaller,

Ayesha Delany-Brumsey, Leah Pope, Sarah Martino, Benjamin Bouvier and Josiah Rich

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:

expansionof overdoseeducation andnaloxone programs;establishmentof comprehensivemedicationassisted

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.

Keywords Criminal justice system, Harm reduction, Prisoners, Illicit drugs, Opioid substitution therapy,

Drug addiction

Paper type Conceptual paper

Background

Overdose epidemic

Globally, there has been a significant increase in drug-related overdose deaths in recent years

(Martins et al., 2015). Currently the USA is experiencing a growing number of overdose deaths.

In 2014, there were over 47,000 overdose deaths and the number of overdoses has increased

137 percent since 2000, making overdose the leading cause of accidental death (Rudd, Aleshire,

Zibbell, Gladden, 2016). Opioid-related deaths are largely responsible for the rise in overdose

fatalities; there was a 200 percent increase in the rate of overdoses involving opioids from 2000

to 2014 (Rudd, Aleshire, Zibbell, Gladden, 2016). In response, the Rudd, Seth, David, Scholl

(2016) has declared opioid-related overdoses a public health epidemic.

Over the past two decades, non-medical prescription opioid use has contributed substantially to

rising overdose rates (Calcaterra et al., 2013). In more recent years, though, national initiatives to

reduce opioid prescribing have produced modest declines in the number of prescription opioids

Received 22 August 2016

Revised 18 November 2016

Accepted 15 December 2016

The authors affiliations can be

found at the end of this article.

DOI 10.1108/IJPH-08-2016-0039 VOL. 13 NO. 1 2017, pp. 25-31, © Emerald Publishing Limited, ISSN 1744-9200

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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