A scoping review of factors that influence opioid overdose prevention for justice-involved populations

Abstract

Background There is a high risk of death from opioid overdose following release from prison. Efforts to develop and implement overdose prevention programs for justice-involved populations have increased in recent years. An understanding of the gaps in knowledge on prevention interventions is needed to accelerate development, implementation, and dissemination of effective strategies. Methods A systematic search process identified 43 published papers addressing opioid overdose prevention in criminal justice settings or among justice-involved populations from 2010 to February 2020. Cross-cutting themes were identified, coded and qualitatively analyzed. Results Papers were coded into five categories: acceptability (n = 8), accessibility (n = 4), effectiveness (n = 5), feasibility (n = 7), and participant overdose risk (n = 19). Common themes were: (1) Acceptability of naloxone is associated with injection drug use, overdose history, and perceived risk within the situational context; (2) Accessibility of naloxone is a function of the interface between corrections and community; (3) Evaluations of overdose prevention interventions are few, but generally show increases in knowledge or reductions in opioid overdose; (4) Coordinated efforts are needed to implement prevention interventions, address logistical challenges, and develop linkages between corrections and community providers; (5) Overdose is highest immediately following release from prison or jail, often preceded by service-system interactions, and associated with drug-use severity, injection use, and mental health disorders, as well as risks in the post-release environment. Conclusion Study findings can inform the development of overdose prevention interventions that target justice-involved individuals and policies to support their implementation across criminal justice and community-based service systems.

The impact of the opioid crisis on U.S. state prison systems

“…A critical component for the reduction of post-release mortality from opioid overdose is linkage of individuals to community-based programs they are likely to use, such as drug treatment, harm reduction, or other health and social services (Zucker, Annucci, Stancliff, & Catania, 2015 ). Such programs can provide access points for naloxone distribution and ongoing prevention interventions (Grella et al, 2021 ).…”

Court-Mandated Treatment Outcomes for Prescribed Opioid Use Disorder: A Gender Based Study

“…Protective factors to prevent pre-and post-treatment adverse effects of OUD, including overdose, best serve the treatment process when applied early. Individuals with criminal justice involvement need collaboration between criminal justice and community providers to access early treatment interventions to ameliorate the risk of overdose and death (Grella et al, 2021).…”

“…According to Rudd et al (2016), the rate of deaths associated to opioid overdose, specifically prescribed opioids, have increased by 200% since 2000. In studies done by Binswanger, Blatchford, Mueller, and Stern (2013), Grella et al (2021) researchers found that overdoses were the leading cause of death of those that had been previously incarcerated. Prisons are ill equipped to address OUD as evidenced by lack of screening and treatment availability and given the physical dependency of OUD; incarceration rather than treatment does not support an efficacious solution.…”

Record linkage studies of drug-related deaths among former adult prisoners who have been released to the community: a scoping review protocol

“… 6 7 12 A scoping review between 2010 and 2020 found 43 publications relating to opioid overdose prevention in justice-involved populations (including correctional and community settings), of which 16 were cohort studies with data linkage. 13 The scoping review identified five core domains regarding opioid overdose prevention: acceptability, accessibility, effectiveness, feasibility and participant overdose risk. 13 The review found evidence of an immediate risk of overdose following release from prison; with the risk factors for opioid overdose including access to drugs, contact with drug using social groups and lack of social and socioeconomic support.…”

“… 13 The scoping review identified five core domains regarding opioid overdose prevention: acceptability, accessibility, effectiveness, feasibility and participant overdose risk. 13 The review found evidence of an immediate risk of overdose following release from prison; with the risk factors for opioid overdose including access to drugs, contact with drug using social groups and lack of social and socioeconomic support. 13 Often, this at-risk group had contact with community-based service providers (after their release and before overdose) thereby pointing to opportunities for overdose prevention interventions during this period.…”