By Pryce S. Michener, Elyse Bianchet, Shannon Fox, Elizabeth A. Evans & Peter D. Friedmann 

Background

Opioid-related overdose is the leading cause of death for people recently released from incarceration, however treatment with medications for opioid use disorder (MOUD) during incarceration can reduce the mortality risk. This study seeks to qualitatively analyze perceptions of post-release overdose risk from the perspectives of people who received MOUD while incarcerated in one of eight Massachusetts jails during 2021–2022 using the Risk Environment Framework to guide analyses.

Methods

N = 38 participants with lived experience of MOUD treatment during incarceration who are now living in the community were interviewed on factors that may contribute to or protect against post-release overdose risk. Themes were identified inductively and deductively using the Risk Environment Framework and its domains, which organizes themes along physical, social, economic, and policy environments on both the micro- and macro- scales.

Results

The physical risk environment included loss of opioid tolerance during incarceration, polysubstance use, and the toxicity of the regional drug supply as key producers of increased risk for post-release overdose. Social drivers of risk included peer group risk norms—including peer-driven harm reduction practices and interpersonal relationships between drug sellers and buyers—as well as macro-level social determinants of health such as housing insecurity and availability of mental health services. Economic drivers of post-release overdose risk included lack of income generation during incarceration and employment challenges. Participants discussed several aspects of policy that contribute to post-release overdose risk, including availability of harm reduction supplies, public health services, and broader policy around MOUD.

Conclusions

The perspectives of people with lived experience are vital to understanding the disproportionate risks of overdose for those recently released from incarceration. Our results highlight the intersectional factors that produce and reproduce the post-release overdose risk environment, providing support for interventions across each domain of the Risk Environment Framework. By capturing perspectives from people with lived experience of OUD and incarceration during this critical period of risk, we can better identify interventions that target and mitigate overdose-related harm in this population.

Harm Reduction Journal (2024) 21:138

By James Austin, Todd Clear, and Richard Rosenfeld

Illinois is one of several states considering how to reduce its prison population amid the pandemic and calls for an end to mass incarceration. In recent years, the state has taken steps to reduce its prison population through judicial discretion, bail reform, and diversion programs. As Illinois’ prison population declines and policymakers, prosecutors, and courts consider alternatives to incarceration, what is the risk to public safety? Is crime likely to increase or decline in the state as those convicted of crimes are released or diverted to other programs? In this study, funded by The Harry Frank Guggenheim Foundation, the authors conclude that Illinois crime rates, which have been on the decline since the 1990s, will continue to decline in a fluctuating pattern, with moderate year-to-year changes. This will be true even if Illinois reduces its prison population by an additional 25% over five years. The authors reached this conclusion by constructing a quantitative model that accounts for Illinois crime trends over nearly four decades and provides a basis for predicting crime rates in the near future. This study is a companion to the 2020 Harry Frank Guggenheim Foundation report Explaining the Past and Projecting Future Crime Rates, which examined national crime trends and reached similar conclusions about crime rates in the near future.   

New York: Harry Frank Guggenheim Foundation. 2020, 23pg

By James Austin, Richard Rosenfeld and Todd Clear

Florida has benefited from the national drop in crime that began in the early 1990s. Its growth in incarceration also paralleled the steady national imprisonment rise of the last forty-five years. Florida’s rate peaked around 2010 and has been declining ever since. Policy makers would benefit from defensible projections of future trends in crime, and especially from estimates of the effect that further reductions in the number of people in jail and prison might have on those trends. The authors of this study developed quantitative models—explained here in non-technical language—of the effects of various demographic and economic factors, as well as the imprisonment rate, on Florida’s past crime rates. They then used these models to project crime trends into the 2020s, both with and without the assumption of a substantial reduction in imprisonment.

New York: Harry Frank Guggenheim Foundation. 2021, 28pg