By Christian Gunadi; Yuyan Shi,

Recreational cannabis legalization (RCL) has been advocated as a way to reduce the number of individuals interacting with the US criminal justice system; in theory, however, cannabis decriminalization can achieve this objective without generating the negative public health consequences associated with RCL. It is still unclear whether RCL can bring additional benefits in terms of reducing cannabis possession arrests in states that have already decriminalized cannabis. OBJECTIVE -  To examine whether RCL was associated with changes in cannabis possession arrests in US states that had already decriminalized cannabis during the study period and whether these changes differed across age and racial subgroups. DESIGN, SETTING, AND PARTICIPANTS - This repeated cross-sectional study used cannabis possession arrest data from the Federal Bureau of Investigation Uniform Crime Reporting Program (UCRP) for US states from 2010 through 2019. Statistical analysis was conducted from October 6, 2021, to October 12, 2022. EXPOSURES -  Implementation of statewide RCL. MAIN OUTCOMES AND MEASURES - Cannabis possession arrest rates per 1000 population per year were assessed with a quasi-experimental difference-in-differences design and were used to estimate the association of RCL with arrest rates in RCL states that had or had not decriminalized cannabis before RCL. This association was also examined in subgroups for age (adults vs youths) and race (Black vs White). RESULTS - This study included UCRP data for 31 US states, including 9 states that implemented RCL during the study period (4 without and 5 with decriminalization) and 22 non-RCL states. In the 4 states that had not decriminalized cannabis before legalization, RCL was associated with a 76.3% decrease (95% CI, −81.2% to −69.9%) in arrest rates among adults. In the 5 states that had already decriminalized cannabis, RCL was still associated with a substantial decrease in adult arrest rates (−40.0%; 95% CI, −55.1% to −19.8%). There was no association of RCL with changes in arrest rates among youths. In addition, changes in arrest rates associated with RCL did not differ among Black and White individuals. CONCLUSIONS AND RELEVANCE -  In this repeated cross-sectional study, RCL was associated with a sizable reduction in cannabis possession arrests among adults in states that had already decriminalized cannabis during the study period (2010-2019), albeit the magnitude was smaller compared with states that had not decriminalized cannabis before RCL. In addition, RCL did not seem to be associated with changes in arrest rates among youths or disparities in arrest rates among Black and White individuals. 

JAMA Netw Open. 2022 Dec 5;5(12):e2244922

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 The Center for Justice Innovation

The Center for Justice Innovation and RxStat convened together stakeholders in the criminal justice, court, and public health systems to discuss the treatment of drug use and prevention of fatal overdoses in the context of the criminal justice system, as well as the integration of harm reduction principles. This document, which maps many of the court-based problem substance use interventions currently utilized across New York City, came out of this forum of experts.

On September 19, 2023, the Center for Justice Innovation and RxStat convened together stakeholders in the criminal justice and court systems, clinicians, and public health experts to discuss the treatment of drug use and prevention of fatal overdoses in the context of the criminal justice system, as well as the integration of harm reduction principles into these and related programs. Among the pre-conference materials distributed were this document, which maps many of the court-based problem substance use interventions currently utilized across New York City. We divided these initiatives into four stages within the timeline of a criminal case: pre-arraignment, arraignment, pre-plea, and post-plea. This categorization is intended to highlight the distinct role that each stage plays within the larger system of treatment and prevention.

New York: The Center for Justice Innovation. 2023, 16pg