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Expanded access to medication in prisons and jails can reduce opioid overdose deaths by 31.6%, a study finds.

The epidemic of opioid-related overdose death persists across the United States, and people released from jails and prisons are at particular risk.

While the benefits of life-saving medications for opioid use disorder—such as methadone, buprenorphine, and extended-release naltrexone—has been documented across hospitals and treatment centers, its uptake has been extremely limited in US prisons and jail settings.

In a new study published in the International Journal of Drug Policy on July 22, researchers from Brown led by Alexandria Macmadu ’14 ScM’15, a doctoral candidate in epidemiology, found in a computer simulation that expanding access to all three medications in prisons and jails can reduce overdose deaths by 31.6 percent in certain circumstances.

According to previous studies, the first two weeks following release from incarceration are associated with a 129-fold increase in overdose risk relative to the general population. During incarceration, tolerance to opioids is diminished or lost, which—combined with disrupted social support networks, limited access to treatments for opioid use disorder, medical comorbidities, and various other socioeconomic conditions—places individuals at a much higher risk for overdose upon release.

“We found that the most overdose deaths were averted when the computer model was set up such that persons initiating therapy at release were retained in care for longer periods,” says Brandon Marshall, PhD, corresponding author on the paper and associate professor of epidemiology. “This finding suggests that, to maximize public health impact, programs should ensure continuity of care by addressing known barriers to accessing treatment for opioid use disorder, such as unstable housing and medical insurance interruptions that often occur as persons are released from prison and jails.”

Co-authors included Jennifer Clarke MPH’04, MD, associate professor of obstetrics and gynecology; Traci Green, PhD, adjunct associate professor of emergency medicine; and Josiah Rich, MD, MPH, professor of medicine. Continue reading here.



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