Examination of postincarceration fatal overdoses after addiction treatment medications in correctional system

Bottom Line: There were fewer postincarceration deaths from overdose among recently released inmates after a program was started to provide medications for addiction treatment (including methadone, buprenorphine or naltrexone) in a state correctional system.

Why The Research Is Interesting: Most correctional facilities in the United States don't initiate or continue to provide medications for addiction treatment to inmates. Rates of opioid overdose are higher immediately after inmates are released from incarceration. A program for screening and treatment with medications for addiction treatment was launched in the Rhode Island Department of Corrections (RIDOC) in 2016. Inmates entering RIDOC who were receiving medications for addiction treatment maintained their medication regimens and community centers helped to link inmates with medication and supportive care after they were released. This research letter is a preliminary examination of that program.

Who and When: All unintentional deaths from overdose in Rhode Island from January to June in 2016 and 2017; individuals who died within 12 months of release from RIDOC

What (Study Measures): Compared the proportion of people who died from accidental overdose who were incarcerated in 2017 with those incarcerated in 2016 since individual-level data of enrollment in the medications for addiction treatment program were unavailable.

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and therefore cannot control all the natural differences that could explain the study findings.

Authors: Traci C. Green, Ph.D., M.Sc., of the Warren Alpert Medical School of Brown University, Providence, Rhode Island, and coauthors

Results: 26 of 179 individuals (14.5 percent) who died of an overdose in the first six months of 2016 were recently incarcerated compared with 9 of 157 (5.7 percent) in the same period in 2017, a 60.5 percent reduction in mortality.

Study Limitations: A small study sample and a lack of data on medications for addiction treatment after an inmate's release were some of the limitations of the study that warrant additional analyses.

Study Conclusions: Identifying and treating opioid use disorder in criminal justice settings, along with linking inmates to medication and supportive care after they are released, is a promising strategy to address high rates of overdose and opioid use disorder.

More information:
Traci C. Green et al. Postincarceration Fatal Overdoses After Implementing Medications for Addiction Treatment in a Statewide Correctional System, JAMA Psychiatry (2018). DOI: 10.1001/jamapsychiatry.2017.4614

Provided by JAMA Psychiatry