Early Effects of COVID-19 on Programs Providing Medications for Opioid Use Disorder in Jails and Prisons

Bandara, Sachini; Kennedy-Hendricks, Alene; Merritt, Sydney; Barry, Colleen L.; Saloner, Brendan

doi:10.1097/adm.0000000000000718

Cited by 28 publications

(48 citation statements)

References 6 publications

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“…Our results are consistent with key messages from the limited evidence base on respiratory infections in incarcerated populations (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(20)(21)(22). The interconnected nature of the residents of congregate institutions means that outbreaks, especially those that penetrate higher occupancy rooms, can quickly become building or prison outbreaks.…”

Section: Discussionsupporting

confidence: 87%

“…Early releases reduce crowding but may cause public unrest ( 11 ). Curtailing in-prison activities (e.g., work or group therapy) limits mixing but is disruptive and may have adverse health effects ( 12 , 13 ). The federal government has issued guidance ( 14 , 15 ) on measures to reduce COVID-19 transmission in correctional settings, but the recommendations lack specificity and evidence of efficacy.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

et al. 2021

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BACKGROUND: Correctional institutions nationwide are seeking to mitigate COVID-19-related risks. OBJECTIVE: To quantify changes to California's prison population since the pandemic began and identify risk factors for COVID-19 infection. DESIGN: For California state prisons (March 1-October 10, 2020), we described residents' demographic characteristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively. PARTICIPANTS: Residents of California state prisons. MAIN MEASURES: Changes in the incarcerated population's size, composition, housing, and activities. For the risk factor analysis, the exposure variables were room type (cells vs. dormitories) and labor participation (any room occupant participating in the prior 2 weeks) and the outcome variable was incident COVID-19 case rates. KEY RESULTS: The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participated in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25-2.80) and residents of rooms with labor participation had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39-1.74). CONCLUSION: Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

et al. 2021

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“…The majority of papers were opinion pieces, with the exception of 10 case studies, [30][31][32][33][34][35][36][37][38][39] seven guidelines, 13-16 40-42 six literature reviews, [43][44][45][46][47][48] five qualitative studies, [49][50][51][52][53] three cross-sectional studies, [54][55][56] three briefings, [57][58][59] three case studies 37 39 60 and one study protocol. 61 All assessed studies were found to be of poor quality (see online supplemental appendix 3).…”

Section: Resultsmentioning

confidence: 99%

Scoping review of mental health in prisons through the COVID-19 pandemic

et al. 2021

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ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

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“… 1 The initial effect of the pandemic created widespread disruptions in the treatment of opioid use disorder (OUD), including in the provision of traditional outpatient services, prescription filling capabilities, 2 and jail-based treatment programs. 3 Additionally, recent survey data suggest that the pandemic and subsequent lockdowns may have created a negative psychological environment that has put many people with substance use disorders at risk for intensification of substance use. 4 , 5 The exact toll of these changes has yet to be calculated, however a recent national study of out-of-hospital cardiac arrests indicated an increase in opioid-related mortality compared to the prior year.…”

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confidence: 99%

Opioid-related Emergency Department Visits During COVID-19 in a Large Health System

Hall

Cruz

Lank

et al. 2021

Journal of Addiction Medicine

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Objective: Multiple states have reported increases in opioid overdose deaths during the coronavirus disease 2019 (COVID-19) pandemic, however little is known about opioid-related presentations to the emergency department (ED). Methods: This was a time series analysis of visits to 7 EDs in greater Chicago, Illinois from October 20, 2019 to July 25, 2020. We compared the number of ED visits for opioid-related diagnoses in the time period preceding the World Health Organization pandemic declaration (prepandemic period, October 20, 2019–July 3, 2020) to the time period following the World Health Organization declaration (pandemic period, March 8, 2020 to July 25, 2020) using a single-group interrupted time series analysis with Newey-West standard errors. We also present data on alcohol-related ED visits for comparison. Results: We evaluated a total of 177,405 visits across the 7 EDs during the study period. The mean number of weekly ED visits in the prepandemic and pandemic periods was 4841 and 4029 weekly visits, respectively. In the interrupted time series analysis, there was no significant immediate effect of the pandemic start on opioid-related ED visits (−0.44 visits per 1000 ED visits, 95% CI −2.47 to 1.58, P = 0.66), however, there was a significant immediate effect of the pandemic start on alcohol-related ED visits (−4.1, 95% CI: −8.25 to −0.01, P < 0.05). Conclusions: Despite reductions in overall ED visit volumes and alcohol-related visits during COVID-19, the number of opioid-related visits was not significantly reduced during the early pandemic. These data reinforce the need to provide comprehensive treatment services for opioid use disorder during the co-occurring COVID-19 and opioid crises.

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Early Effects of COVID-19 on Programs Providing Medications for Opioid Use Disorder in Jails and Prisons

Cited by 28 publications

References 6 publications

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

Scoping review of mental health in prisons through the COVID-19 pandemic

Opioid-related Emergency Department Visits During COVID-19 in a Large Health System

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