Prison-based harm reduction services are needed to address the dual substance use disorder and infectious disease epidemics in US prisons

Ohringer, Alison; Ezer, Tamar; Serota, David P.

doi:10.1016/j.eclinm.2020.100367

Cited by 8 publications

(7 citation statements)

References 3 publications

(4 reference statements)

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“…Additionally, ensuring that harm reduction (e.g., naloxone and sterile injection equipment) is available during incarceration and post-release is critical. Incarceration causes disruptions in social networks and access to care, ultimately leading to the potential for someone to overdose post-release (Brinkley-Rubinstein et al, 2017 ; Joudrey et al, 2019 ; Ohringer et al, 2020 ). Guaranteeing access to MOUD, naloxone, and syringe services during incarceration, during the transition out of the carceral system, and post-release could reduce overdose risk and may also increase continuity of care (Brinkley-Rubinstein et al, 2017 ; Joudrey et al, 2019 ; Ohringer et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Identifying structural risk factors for overdose following incarceration: a concept mapping study

Nall,

Jurecka,

Ammons

et al. 2024

Health Justice

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Background Currently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities. People with lived experiences in the criminal legal system and with substance use disorder hold unique perspectives and must be involved in the research process. Objective To identify perceived factors that impact overdose following release from incarceration among people with direct criminal legal involvement and experience with substance use. Methods Within a community-engaged approach to research, we used concept mapping to center the perspectives of people with personal experience with the carceral system. The following prompt guided our study: “What do you think are some of the main things that make people who have been in jail or prison more and less likely to overdose?” Individuals participated in three rounds of focus groups, which included brainstorming, sorting and rating, and community interpretation. We used the Concept Systems Inc. platform groupwisdom for our analyses and constructed cluster maps. Results Eight individuals (ages 33 to 53) from four states participated. The brainstorming process resulted in 83 unique factors that impact overdose. The concept mapping process resulted in five clusters: (1) Community-Based Prevention, (2) Drug Use and Incarceration, (3) Resources for Treatment for Substance Use, (4) Carceral Factors, and (5) Stigma and Structural Barriers. Conclusions Our study provides critical insight into community-identified factors associated with overdose following incarceration. These factors should be accounted for during resource planning and decision-making.

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Section: Discussionmentioning

confidence: 99%

Identifying structural risk factors for overdose following incarceration: a concept mapping study

Nall,

Jurecka,

Ammons

et al. 2024

Health Justice

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“…ID surveillance in jails is a vital opportunity to protect individual and population health both within jails and in the local community upon release. Identifying ID in carceral settings presents an opportunity to also address OUD and SUD as they are commonly syndemic in populations in jails and prisons [ 40 ]. Comprehensive healthcare screenings in jails can contribute to a reduction in OUD/SUD-related morbidity and mortality, which occurs at much higher rates in populations that end up in prisons and jails than in the general population [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Infectious disease surveillance in U.S. jails: Findings from a national survey

et al. 2022

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While infectious diseases (ID) are a well-documented public health issue in carceral settings, research on ID screening and treatment in jails is lacking. A survey was sent to 1,126 jails in the United States to identify the prevalence of health screenings at intake and characteristics of care for ID; 371 surveys were completed correctly and analyzed. Despite conflicting Centers for Disease Control (CDC) guidance, only seven percent of surveyed jails test individuals for HIV at admission. In 46% of jails, non-healthcare personnel perform ID screenings. Jails in less urban areas were more likely to report healthcare screenings performed by correctional officers. Survey findings indicate that HIV, HCV and TB testing during jail admissions and access to PrEP are severely lacking in less urban jails in particular. Recommendations are provided to improve ID surveillance and address the burden of ID in correctional facilities.

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“…Testing in high HCV prevalence settings, such as drug treatment programs, SEPs, prisons, and jails can identify undiagnosed HCV infections among those who may not be engaged in primary care [ 24 ]. Correctional institutions provide critical opportunities for conducting HCV prevention, education, testing, and treatment, including strategies to prevent reinfection during incarceration following virologic cure [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Disparities in risk perception and low harm reduction services awareness, access, and utilization among young people with newly reported hepatitis C infections in California, 2018

et al. 2021

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Background Newly reported hepatitis C virus (HCV) infections in California increased 50% among people 15–29 years of age between 2014 and 2016. National estimates suggest this increase was due to the opioid epidemic and associated increases in injection drug use. However, most of California’s 61 local health jurisdictions (LHJs) do not routinely investigate newly reported HCV infections, so these individuals’ risk factors for infection are not well understood. We sought to describe the demographics, risk behaviors, and utilization of harm reduction services in California’s fastest-rising age group of people with newly reported hepatitis C infections to support targeted HCV prevention and treatment strategies. Methods California Department of Public Health invited LHJs to participate in enhanced surveillance if they met criteria indicating heightened population risk for HCV infection among people ages 15–29. From June–December 2018, eight LHJs contacted newly reported HCV cases by phone using a structured questionnaire. Results Among 472 total HCV cases who met the inclusion criteria, 114 (24%) completed an interview. Twenty-seven percent of respondents (n = 31) had ever been incarcerated, of whom 29% received a tattoo/piercing and 39% injected drugs while incarcerated. Among people who injected drugs (PWID)—36% (n = 41) of all respondents—68% shared injection equipment and many lacked access to harm reduction services: 37% knew of or ever used a needle exchange and 44% ever needed naloxone during an overdose but did not have it. Heroin was the most frequently reported injected drug (n = 30), followed by methamphetamine (n = 18). Pre-diagnosis HCV risk perception varied significantly by PWID status and race/ethnicity: 76% of PWID vs. 8% of non-PWID (p < 0.001), and 44% of non-Hispanic White respondents vs. 22% of people of color (POC) respondents (p = 0.011), reported thinking they were at risk for HCV before diagnosis. Eighty-nine percent of all respondents reported having health insurance, although only two had taken HCV antiviral medications. Conclusions Among young people with HCV, we found limited pre-diagnosis HCV risk perception and access to harm reduction services, with racial/ethnic disparities. Interventions to increase harm reduction services awareness, access, and utilization among young PWID, especially young PWID of color, may be warranted.

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Prison-based harm reduction services are needed to address the dual substance use disorder and infectious disease epidemics in US prisons

Cited by 8 publications

References 3 publications

Identifying structural risk factors for overdose following incarceration: a concept mapping study

Identifying structural risk factors for overdose following incarceration: a concept mapping study

Infectious disease surveillance in U.S. jails: Findings from a national survey

Disparities in risk perception and low harm reduction services awareness, access, and utilization among young people with newly reported hepatitis C infections in California, 2018

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