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

Int J Prison Health. 2017 Mar 13;13(1):25-31. doi: 10.1108/IJPH-08-2016-0039.


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.

Keywords: Criminal justice system; Drug addiction; Harm reduction; Illicit drugs; Opioid substitution therapy; Prisoners.

MeSH terms

  • Cooperative Behavior
  • Criminals / statistics & numerical data
  • Drug Overdose / epidemiology
  • Drug Overdose / prevention & control*
  • Female
  • Harm Reduction*
  • Humans
  • Male
  • Prisoners / statistics & numerical data*
  • Risk Factors
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / prevention & control*
  • United States
  • Vulnerable Populations / statistics & numerical data