Noa Krawczyk1, Kristin E Schneider2, Matthew D Eisenberg3, Tom M Richards3, Lindsey Ferris4, Ramin Mojtabai2, Elizabeth A Stuart5, B Casey Lyons6, Kate Jackson6, Jonathan P Weiner3, Brendan Saloner3. 1. NYU Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York NY 10016, USA; Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 North Broadway, Baltimore, MD, 21205, USA. Electronic address: noa.krawczyk@nyulangone.org. 2. Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 North Broadway, Baltimore, MD, 21205, USA. 3. Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA. 4. Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA; The Chesapeake Regional Information System for our Patients, 7160 Columbia Gateway Drive, Suite 100, Columbia MD 21046, USA. 5. Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 624 North Broadway, Baltimore, MD, 21205, USA; Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, Baltimore, MD, USA. 6. Maryland Department of Health, 55 Wade Avenue, Catonsville, MD, 21228 USA.
Abstract
BACKGROUND: Persons who interact with criminal justice and hospital systems are particularly vulnerable to negative health outcomes, including overdose. However, the relationship between justice involvement, healthcare utilization and overdose risk is not well-understood. This data linkage study seeks to improve our understanding of the link between different types of justice involvement as well as hospital interaction and risk of fatal opioid overdose among persons with incarcerations, arrests and parole/probation records for drug and property crimes in Maryland. METHODS: Maryland statewide criminal justice records were obtained for 2013-2016. Data were linked at the person-level to an all-payer hospitalization database and overdose death records for the same years. Logistic regression was performed to determine which criminal justice and hospital characteristics were associated with greatest risk of overdose death. RESULTS: 89,591 adults had criminal-justice records and were included in the study. During the 2013-2016 study period, 4108 (4.59 %) were hospitalized for a non-fatal opioid overdose, and 519 (0.58 %) died of opioid overdose. Strongest risk factors for death included being older, being white, having had an inpatient or emergency hospitalization, having had more arrests, having been arrested for a drug charge (vs. property charge), having a misdemeanor drug charge (vs. a felony charge), and having been released from incarceration during the study period. CONCLUSION: Linking corrections and healthcare information can help advance understanding of risk and target overdose prevention interventions directed at justice-involved individuals with greatest need.
BACKGROUND:Persons who interact with criminal justice and hospital systems are particularly vulnerable to negative health outcomes, including overdose. However, the relationship between justice involvement, healthcare utilization and overdose risk is not well-understood. This data linkage study seeks to improve our understanding of the link between different types of justice involvement as well as hospital interaction and risk of fatal opioid overdose among persons with incarcerations, arrests and parole/probation records for drug and property crimes in Maryland. METHODS: Maryland statewide criminal justice records were obtained for 2013-2016. Data were linked at the person-level to an all-payer hospitalization database and overdose death records for the same years. Logistic regression was performed to determine which criminal justice and hospital characteristics were associated with greatest risk of overdose death. RESULTS: 89,591 adults had criminal-justice records and were included in the study. During the 2013-2016 study period, 4108 (4.59 %) were hospitalized for a non-fatal opioid overdose, and 519 (0.58 %) died of opioid overdose. Strongest risk factors for death included being older, being white, having had an inpatient or emergency hospitalization, having had more arrests, having been arrested for a drug charge (vs. property charge), having a misdemeanor drug charge (vs. a felony charge), and having been released from incarceration during the study period. CONCLUSION: Linking corrections and healthcare information can help advance understanding of risk and target overdose prevention interventions directed at justice-involved individuals with greatest need.
Authors: Juliet M Flam-Ross; Josh Lown; Prasad Patil; Laura F White; Jianing Wang; Ashley Perry; Dennis Bailer; Michelle McKenzie; Anthony Thigpen; Roxxanne Newman; Meko Lincoln; Tyrone Mckinney; Dana Bernson; Joshua A Barocas Journal: Int J Drug Policy Date: 2021-12-09
Authors: Magdalena Cerdá; Noa Krawczyk; Leah Hamilton; Kara E Rudolph; Samuel R Friedman; Katherine M Keyes Journal: Annu Rev Public Health Date: 2021-11-30 Impact factor: 21.981
Authors: Wei-Hsuan Lo-Ciganic; Julie M Donohue; Eric G Hulsey; Susan Barnes; Yuan Li; Courtney C Kuza; Qingnan Yang; Jeanine Buchanich; James L Huang; Christina Mair; Debbie L Wilson; Walid F Gellad Journal: PLoS One Date: 2021-03-18 Impact factor: 3.240