Alexandria Macmadu1, William C Goedel2, Joëlla W Adams2, Lauren Brinkley-Rubinstein3, Traci C Green4, Jennifer G Clarke5, Rosemarie A Martin6, Josiah D Rich1, Brandon D L Marshall7. 1. Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA; The Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third Street, Providence, RI, USA. 2. Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA. 3. Department of Social Medicine, University of North Carolina at Chapel Hill, 333 South Columbia Street, Chapel Hill, NC, 27516, USA; Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 South Columbia Street, Chapel Hill, NC, 27514, USA. 4. Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA; Department of Emergency Medicine, Boston University Medical Center, 725 Albany Street, Boston, MA, 02118, USA. 5. Rhode Island Department of Corrections, 40 Howard Avenue, Cranston, RI, 02920, USA. 6. Department of Behavioral and Social Science, Brown University, 121 South Main Street, Providence, RI 02903, USA. 7. Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA. Electronic address: brandon_marshall@brown.edu.
Abstract
BACKGROUND: Medications for opioid use disorder (OUD) are the most effective treatment for OUD, but uptake of these life-saving medications has been extremely limited in US prisons and jail settings, and limited data are available to guide policy decisions. The objective of this study was to estimate the impact of screening and treatment with medications for OUD in US prisons and jails on post-release opioid-related mortality. METHODS: We used data from the National Center for Vital Statistics, the Bureau of Justice Statistics, and relevant literature to construct Monte Carlo simulations of a counterfactual scenario in which wide scale uptake of screening and treatment with medications for OUD occurred in US prisons and jails in 2016. RESULTS: Our model predicted that 1840 (95% Simulation Interval [SI]: -2757 - 4959) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated. The model also predicted that approximately 4400 (95% SI: 2675 - 5557) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated and were retained in treatment post-release. These estimates correspond to 668 (95% SI: -1008 - 1812) and 1609 (95% SI: 972 - 2037) lives saved per 10,000 persons incarcerated, respectively. CONCLUSIONS: Prison and jail-based programs that comprehensively screen and provide treatment with medications for OUD have the potential to produce substantial reductions in opioid-related overdose deaths in a high-risk population; however, retention on treatment post-release is a key driver of population level impact.
BACKGROUND: Medications for opioid use disorder (OUD) are the most effective treatment for OUD, but uptake of these life-saving medications has been extremely limited in US prisons and jail settings, and limited data are available to guide policy decisions. The objective of this study was to estimate the impact of screening and treatment with medications for OUD in US prisons and jails on post-release opioid-related mortality. METHODS: We used data from the National Center for Vital Statistics, the Bureau of Justice Statistics, and relevant literature to construct Monte Carlo simulations of a counterfactual scenario in which wide scale uptake of screening and treatment with medications for OUD occurred in US prisons and jails in 2016. RESULTS: Our model predicted that 1840 (95% Simulation Interval [SI]: -2757 - 4959) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated. The model also predicted that approximately 4400 (95% SI: 2675 - 5557) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated and were retained in treatment post-release. These estimates correspond to 668 (95% SI: -1008 - 1812) and 1609 (95% SI: 972 - 2037) lives saved per 10,000 persons incarcerated, respectively. CONCLUSIONS: Prison and jail-based programs that comprehensively screen and provide treatment with medications for OUD have the potential to produce substantial reductions in opioid-related overdose deaths in a high-risk population; however, retention on treatment post-release is a key driver of population level impact.
Authors: R J Winter; M Stoové; L Degenhardt; M E Hellard; T Spelman; R Jenkinson; D R McCarthy; S A Kinner Journal: Drug Alcohol Depend Date: 2015-06-16 Impact factor: 4.492
Authors: John Marsden; Garry Stillwell; Hayley Jones; Alisha Cooper; Brian Eastwood; Michael Farrell; Tim Lowden; Nino Maddalena; Chris Metcalfe; Jenny Shaw; Matthew Hickman Journal: Addiction Date: 2017-03-01 Impact factor: 6.526
Authors: Lia N Pizzicato; Rebecca Drake; Reed Domer-Shank; Caroline C Johnson; Kendra M Viner Journal: Drug Alcohol Depend Date: 2018-06-05 Impact factor: 4.492
Authors: Joshua D Lee; Peter D Friedmann; Timothy W Kinlock; Edward V Nunes; Tamara Y Boney; Randall A Hoskinson; Donna Wilson; Ryan McDonald; John Rotrosen; Marc N Gourevitch; Michael Gordon; Marc Fishman; Donna T Chen; Richard J Bonnie; James W Cornish; Sean M Murphy; Charles P O'Brien Journal: N Engl J Med Date: 2016-03-31 Impact factor: 91.245
Authors: Eric Tatara; John Schneider; Madeline Quasebarth; Nicholson Collier; Harold Pollack; Basmattee Boodram; Sam Friedman; Elizabeth Salisbury-Afshar; Mary Ellen Mackesy-Amiti; Jonathan Ozik Journal: IEEE Int Symp Parallel Distrib Process Workshops Phd Forum Date: 2021-06-24
Authors: Elizabeth A Evans; Ekaterina Pivovarova; Thomas J Stopka; Claudia Santelices; Warren J Ferguson; Peter D Friedmann Journal: J Subst Abuse Treat Date: 2022-02-23
Authors: Adrian J Dunlop; Bethany White; Jillian Roberts; Michelle Cretikos; Dena Attalla; Rod Ling; Andrew Searles; Judith Mackson; Michael F Doyle; Elizabeth McEntyre; John Attia; Christopher Oldmeadow; Mark V Howard; Terry Murrell; Paul Steven Haber; Nicholas Lintzeris Journal: Addiction Date: 2021-07-16 Impact factor: 7.256