By Mardet Homans, Denise M. Allen & Yesenia Mazariegos

The use of Medication Assisted Treatment (MAT), and specifically buprenorphine, to address opioid use disorder (OUD) is considered the gold standard of care in the community (Substance Abuse and Mental Health Service Administration (SAMHSA), 2023). However, while support of its use in correctional settings is expanding, and there are national promising practice guidelines, it remains underutilized within jails and prisons in the United States (U.S.) (National Commission on Correctional Healthcare (NCCHC), 2018; Friedmann et al., 2012). The efficacy of MAT to reduce opiate withdrawal, curb cravings, and support positive health, behavioral health, and criminal justice outcomes, including reductions in overdose deaths and recidivism, has gained national attention from criminal justice advocacy groups and policymakers. Jails and correctional agencies have been taken to court over the provision of MAT for incarcerated individuals with OUD. And state and federal courts have ruled denial of MAT for incarcerated individuals with OUD violates the Americans with Disabilities Act (ADA) (Legislative Analysis and Public Policy Association (LAPPA), n.d.). The California Department of Corrections and Rehabilitation (CDCR) and California Correctional Health Care Services (CCHCS) are at the forefront of providing MAT in a correctional setting under the Integrated Substance Use Disorder Treatment (ISUDT) Program. The ISUDT Program begins at intake into CDCR with a substance use disorder (SUD) screening and assessment and linkage to behavioral interventions and MAT with a targeted focus on preparing CDCR residents for release. This paper seeks to document the provision of MAT in correctional settings since it is expanding rapidly within the U.S. and there is currently not a national inventory of programs or practices. In addition, this paper aims to document best practices and lessons learned from California and other correctional systems that can be used to guide expansion of MAT to justice-involved populations. Contained in the appendix of this report is a comprehensive review of information regarding the current availability of MAT in U.S. jails and prisons.

Key Findings • According to the Bureau of Justice Statistics (BJS) less than 1% of the Federal Bureau of Prisons (BOP) population received MAT in 2021. • Based on a review of publicly available information, it does appear that five states – Alabama, Mississippi, Nebraska, South Dakota, and Wyoming offer MAT in their correctional institutions. • A number of states have or are currently piloting MAT in corrections. • Besides California, only 14 states offer comprehensive MAT services at either intake and/or release in a considerable number of its jails and prisons. • Locating details regarding MAT provision on many state and local correctional websites is difficult or is missing altogether. This may present as a barrier to SUD treatment and discourage justice-involved individuals or their families from seeking MAT. • Overall, there is significant variability among states regarding the provision of MAT to incarcerated individuals.

Irvine, CA: Center for Evidence‐Based Corrections University of California, Irvine 2023. 18p.

By James Hess and Susan Turner

California Prison Industry Authority (CALPIA) is a self-supporting training and production program currently operating within the California Department of Corrections and Rehabilitation (CDCR). CALPIA provides training, certification, and employment to inmates in a variety of different fields. The goods and services produced by CALPIA are sold to the state and other government entities, which provides an economic benefit to the state. In addition to the vocational and economic aspect of the program, one of CALPIA’s missions is to reduce the subsequent recidivism of their inmate participants. In 2021, the Center for Evidence-Based Corrections prepared a report on the recidivism outcomes for individuals who had participated in CALPIA programs for at least six months (Hess and Turner, 2021). That report examined the effect of participation in CALPIA on the recidivism of CDCR inmates by comparing CALPIA participants with at least 6 months in the program and released between August 2014 and July 2018 with inmates who were accepted into the CALPIA program but were released before they could actively participate (i.e., the “Waitlist” group). That report found that participation in CALPIA was associated with reduced offending. CALPIA individuals had lower rates of arrests, conviction, and incarceration during a three-year follow-up than a Waitlist comparison group. Although the sample size for our analysis of Career Technical Education (CTE) was small, participation in this CALPIA program yielded lower recidivism rates than other CALPIA program participation. This report further analyzes the sample of individuals who participated in CALPIA programs by separating the CALPIA programs into thirteen different groups, placing similar programs together. Thus, it is a comparison within CALPIA programs only. The analysis strategy is the same as used in our previous report: we examine arrest, conviction and return to custody calculated at one-, two- and three-year post release for the individuals. Propensity score analyses were used to adjust for baseline differences in the groups. Our findings suggest that the enterprise programs perform about equally well with the exception of CTE, which appears to do slightly better than other enterprises. We also found a positive effect for CTE in our earlier report. Several other programs show patterns of higher or lower recidivism which are suggestive but not conclusive due to lack of statistical significance. We note that small sample sizes, using propensity score analyses, may have limited our ability to detect significant differences.

Irvine, CA: Center for Evidence‐Based Corrections University of California, Irvine 2023. 20p

By H. Daniel Butler, Natasha Frost, Nancy Rodriguez, Melinda Tasca, and Jillian Turanovic

Prison violence is a persistent problem for institutional corrections and the rehabilitation of incarcerated individuals. Estimates suggest that one in three men and one in four women in prison experience physical violence, while over half of correctional staff express fear of serious injury or death while on the job. However, these statistics are likely underreported due to limited data sources and challenges in data collection and reporting. As a result, the true prevalence of prison violence remains uncertain. In response to this pressing issue, with support of Arnold Ventures, the Prison Violence Consortium was established to better understand the scale, scope, and consequences of prison violence. The Consortium brought together researchers and practitioners from seven state correctional systems: Arizona, Colorado, Massachusetts, Ohio, Oregon, Pennsylvania, and Texas. Through a multi-strategy approach, we collected and analyzed data from a variety of sources, including official records, self-reported data, and interviews from incarcerated persons and correctional staff. A key finding from our work is that, much like the “dark figure of crime” in general society, there is a substantial “dark figure” of prison violence. This discovery underscores that the current practices of documenting and examining prison violence are insufficient, as the majority of prison violence is not reported. Without a national comprehensive strategy to improve the accuracy of how we measure prison violence, efforts to reduce it will be inconsistent and likely ineffective.

Irvine, CA: UC Irvine School of Social Ecology, 2024. 12p.

By Nancy Rodriguez, H. Daniel Butler, Natasha Frost, Melinda Tasca, and Jillian Turanovic

This policy brief presents the findings of our multi-strategy approach, spearheaded by the Prison Violence Consortium, to examine the sources and consequences of prison violence. We capture prison violence using data on guilty violent infractions, violent incident reports, and interviews with incarcerated persons and correctional employees. We offer solution-driven recommendations to policymakers, institutional leaders, prison researchers, and other stakeholders, aiming to enhance prison safety and more effectively address institutional violence nationwide..

Key Findings ● Perpetrators of Violence & Timing: ● Prison violence was concentrated among a small subset of persons, as 10% of the population accounted for more than 50% of guilty violent infractions. ● Personal characteristics related to guilty violent infractions included younger age at admission, lower education, longer sentences, violent criminal histories, gang affiliations, and greater mental health needs. ● Most people (63%) committed guilty violent infractions within 6-12 months of admission, with fewer than 10% remaining violent throughout their incarceration. ● Common Forms & Situational Factors: ● Most violence (71%) occurred between incarcerated persons, while 29% was directed at staff, according to the incident reports. ● The most prevalent form of violence was fights between persons (38%), followed by assaults on persons (26%), assaults on staff (17%), biohazard incidents (13%), and unwitnessed physical altercations (6%). ● Violence most often occured in cells or housing areas (39%) and common areas (e.g., cafeteria and yard) (31%). ● Weapons and contraband were mentioned in 10% of the incident reports.

Irvine, CA: UC Irvine School of Social Ecology, Prison Violence Consortium, 2024. 23p.

Correctional Association of New York

The Correctional Association of New York (CANY) maintains an extraordinarily deep and broad understanding of New York’s state correctional facilities. This understanding allows for nuanced assessment of the greatest challenges DOCCS faces in safely operating institutions that support rehabilitation, public safety, and human dignity. CANY’s vantage also affords the ability to identify examples of good policy and practice, of which there are many within DOCCS. The following recommendations, which take into consideration both persistent challenges and opportunities to scale up examples of excellence, were submitted to DOCCS for a statutory 60-day review period on October 9, 2024—two months to the day before Robert Brooks was fatally assaulted at Marcy Correctional Facility. These recommendations arise from CANY’s unique historical role as the independent oversight entity for state correctional facilities and activities authorized by Correction Law 146(3), which grants the organization authority “to access, visit, inspect, and examine all state correctional facilities with seventy-two hours advance notice to the department.” In FY24, CANY conducted 19 prison monitoring visits; interviewed more than 1,000 incarcerated individuals and more than one hundred state employees who work in these facilities; received hundreds of phone calls, letters, and website inquiries from or on behalf of incarcerated people seeking assistance; distributed thousands of surveys; and published 15 public-facing work products including reports on monitoring visits, dashboards of processed administrative data, data analysis, and legislative testimony. To inform the discussion about prison closures, CANY published a series of tools that allow stakeholders to view staffing levels by facility: Mapping Closures, Capacity, Staffing, and the

CANY, 2025. 7p.

By Jayne Price

This report forms part of PRT’s National Lottery Community Fund funded Building Futures Programme that, since 2020, has been exploring the experiences of people serving long-term prison sentences. The programme has defined its long-term cohort to include those men that will spend 10 or more years in prison and eight years or more for women. Based on consultation with 121 men and women aged 50 and over serving these sentences in 39 prisons in the UK, it provides insights into the age-specific experiences of this cohort. It aims to influence positive changes that would provide a more humane prison experience that recognises the distinct needs of this group. The prison population is ageing (around 17% of people inside are aged 50 and over). By July 2025 it is projected that the population aged 50 years and over will increase from 14,193 (November 2022) to 14,800. This shift is being driven by increased longevity amongst the general population as well as specific patterns of crime and sentencing. These trends are compounding pressures on a system that has been overcrowded every year since 1994 and where staff shortages continue to dog the system. These trends present significant challenges to the government, the prison system, those who live and work within it, and those responsible for providing services, including health and social care. These challenges include meeting human rights and equalities duties, such as the right to dignity and family life, and the right not to be discriminated against due to protected characteristics (including age and disability). These concerns have helped to drive an increase in research on the experience of older people in prison. For example, in 2020 the House of Commons Justice Committee published the findings of its inquiry into the ageing prison population. It found poor coordination between prisons, local authorities and social care providers; high levels of inconsistency in reasonable adjustments to meet the needs of those with disabilities; and a shortage of activities tailored for and accessible to older people in prison. The committee called for a national strategy for older prisoners, concluding that: “The greater needs of older prisoners and the challenges many prisons face in meeting these warrants a specific policy for the cohort.” PRT was one of many organisations to welcome the government’s commitment to produce such a strategy and its announcement in October 2020 that a steering group had begun to work on priorities that would include measures to ensure that older people in prison: • Are held in the most appropriate environments. • Can access a purposeful regime within prison. • Can access health and social care services equivalent to those within the community. • Are prepared for their release and resettled effectively. Findings The Older Offender Strategy is yet to be published. For this reason, our proposals are incorporated under our central recommendation that, as a matter of urgency, the government should publish a draft national strategy for rapid consultation and final publication before the end of the parliamentary year. These proposals are based on our consultation, and this report aims to ensure that the experiences, needs and ideas of older people with lived experience of prison can contribute to this positive change. Below we summarise key themes identified by participants. • Sentencing and adapting to prison life. For many participants, having already ‘lived a life’ minimised the feeling of ‘missing out’ and provided a sense of emotional maturity, which made adapting to the sentence easier than if it had happened at an earlier life-stage. However, this could also exacerbate people’s sense of loss. Having had independence, with the ability to make choices and have ‘normal’ responsibilities, the loss of autonomy was hard to accept. There were few opportunities to grieve this previous life, and respondents felt themselves becoming deskilled, disconnected, and institutionalised. • Relationships outside. Participants spoke about alternate lives continuing outside, with families and friends moving on without them. They talked about how having limited relationships with people on the outside impacted their motivation for leaving prison, and compounded feelings of loneliness and disconnection. Many had or expected to experience bereavements of loved ones whilst inside or have been/will be ‘deserted’ by family members unwilling to maintain their relationship. Some will leave prison with no friends or family to return to. Others are faced with the prospect of their own death in prison. • Purposeful activity. Many participants felt that education, behavioural programmes, and other activities were focused on the needs of younger people and/or were difficult to access. They reported few opportunities to engage with programmes aimed at the older prisoner cohort, and a high number of activities were based on employment, which was not always relevant to this group. Some wanted more opportunities to use the skills they had as a way of using their time purposefully, including peer mentoring or teaching roles that could benefit others. • Relationships inside. Despite the desire to provide support to younger prisoners, participants reported that the relationship between different age groups in prison could sometimes be strained. Older prisoners spoke of favouring a quieter, calmer environment, and being more compliant. The risk of elderly prisoners becoming vulnerable to intimidation and humiliation around their age-related health needs was also raised. • Health and wellbeing. Participants spoke about the importance of dignity around growing old in prison, particularly in relation to health and social care. For example, some shared instances of being unnecessarily cuffed when attending hospital visits. As participants age, the importance of these issues grows. From menopause to mobility-restricting conditions, participants faced a multitude of health concerns and faced barriers in getting the healthcare they required. They felt that their diet, physical space and day-to-day lifestyles (often sedentary and isolated) accelerated the onset of frailty and worsened health outcomes.

London: Prison Reform Trust, 2024. 52p.

By Claudia Vince and Emily Evison

Progression refers to the processes through which people in prison move through the system towards release. This includes engaging in formal programmes and interventions to reduce their risk levels, as well as spending time in different prison spaces, including lower security conditions. Often, progression and risk as concepts are conflated and many prisoners report feeling confused by what is being asked of them. For those serving long sentences, their route to freedom is determined by sentence progression. Therefore, progression is a key concern for people serving long and indeterminate prison sentences. Our previous work has highlighted some challenges faced by long-sentenced prisoners in the male estate, including how prisoners often feel confused and uncertain about how they are meant to progress, and to make positive, productive use of their time. Many prisoners we consulted with noted they spent years – and sometimes decades – feeling stagnant and stuck in the system, unable to engage in meaningful personal development.1 For women serving long sentences, opportunities for meaningful progression are consistently reported as a major concern. A lack of specialist spaces for long-termers, issues surrounding what programmes are available in each prison, and a lack of tailored support from staff mean many women are at a loss in how to progress through their sentence. Our third Invisible Women briefing will focus on the lived reality of how it feels as a woman to serve a long prison sentence, paying attention to the ways the prison service does – and does not – equip women to progress through their sentence towards release. The briefing is the result of long-term consultation work with our Building Futures Working Groups in HMPs Send and Bronzefield, ad hoc groups in HMP New Hall, responses to consultation questions from women in our Building Futures Network, and consultation with a woman now living in the community

London: Prison Reform Trust, 2024. 20p.

By Prison Reform Trust

With the advent of the 21st century, there has been increased emphasis on the ‘movement for public and service user involvement in human service education and research’, which constitutes ‘the knowledge base of the services and practitioners we may all need to turn to at particular times in our lives for help and support’ (Beresford & McLaughlin 2020). Terminology such as ‘service users’, ‘experts by experience’, and ‘people with lived experience’ are somewhat broad and contested (see Livingstone & Cooper 2004; Repper & Breeze 2007; McLaughlin 2009), and seek to describe individuals and groups who have first-hand experience of or have been in contact with a range of services (typically but not exclusively provided by the public sector) and have amassed expertise related to the impact of these services. This includes sectors such as physical and mental health, social care, education, as well as criminal justice, in particular prisons and probation. Inclusion of the perspectives of service users in the fields related to social work, health and mental health services increasingly constitutes embedded practice. The following report: • Provides a rationale for engaging service users in prison officer training. • Summarises key literature on what makes a high performing prison officer, with emphasis on the areas where the perceptions of staff, prisoners, policy makers and experts without lived experienced overlap. • Explores examples of service user involvement with staff training from the literature.

Literature searches were conducted using GoogleScholar and idiscover. While there has been a marked increase in literature related to service user involvement in research and evaluation practices, there remains a distinct deficiency in literature related to their involvement in the recruitment and assessment of staff. This is especially acute in the field of criminal justice, in which service users continue to complain of paternalistic or distrusting attitudes and tokenistic attempts at inclusion outside of programmes related to peer mentoring (Buck et al. 2020). Academic literature analysing service user involvement tends to approach the topic from the perspective of the experience of service user participation in research. Methods employed tend to be qualitative in nature, focus on storytelling, focus groups and interviews, with small samples, or take an autobiographic or semi-biographic approach. Outside the academic literature, the focus tends to be on positioning statements, statements of purpose, and advice and toolkits. Considering the absence of pertinent literature, this review draws on grey literature, including publications, studies, and reports in the fields of mental health and social care to demonstrate that a) meaningful inclusion of service users in staff recruitment and evaluation is possible, and b) that there are several methods pertinent to this area of research that exist within the broader literature

London: Prison Reform Trust, 2024, 45p.

By Eli Miller, Bryan D. Martin, and Chad M. Topaz

During the early stages of the COVID-19 pandemic in 2020, Mayor Bill de Blasio ordered the release of individuals incarcerated in New York City jails who were at high risk of contracting the disease and at low risk of committing criminal reoffense. Using public information, we construct and analyze a database of nearly 350,000 incarceration episodes in the city jail system from 2014—2020, paying special attention to what happened during the week of March 23—29, 2020, immediately following the mayor’s order. In concordance with de Blasio’s stated policy, we find that being discharged during this focus week is associated with a lower probability of readmission as compared to being discharged during the same calendar week in previous years. Furthermore, comparing the individuals discharged during the focus week of 2020 to those discharged during the same calendar week in previous years, we find that the former group was, on average, slightly older than the latter group, although the difference is not large. Additionally, the individuals in the former group had spent substantially longer in jail than those in the latter group. With the release of long-serving individuals demonstrated to be feasible, we also examine how the jail population would have looked over the past six years had caps in incarceration been in place. With a cap of one year, the system would experience a 15% decrease in incarceration. With a cap of 100 days, the reduction would be over 50%. Because our results are only as accurate as New York City’s public-facing jail data, we discuss numerous challenges with this data and suggest improvements related to the incarcerated individual’s age, gender, race, and more. Finally, we discuss the policy implications of our work, highlight some opportunities and challenges posed by incarceration caps, and suggest key areas for reform. One such reform might involve identifying and discharging low-risk individuals sooner in general, which might be feasible given the de Blasio administration’s actions during the early stages of COVID-19.

PLoS ONE 17(1): 2022, 20p.

By Andrew Blum and Alfredo Malaret Baldo

The problem is as old as the justice system itself—how to reduce the chance that an individual reoffends

after they commit an offense and become involved with the justice system. This challenge of reducing

recidivism remains critical. According to the Prison Policy Initiative, there are over 120,000 individuals in

state prisons in California. Another 380,000 cycle through jails in California every year. In 2021, roughly

25,000 individuals were released from prison in California. This is the scope of the challenge. In San

Diego County, a wide variety of agencies and organizations are working to address the recidivism

challenge. In addition, although there is no way to measure this accurately, there is a willingness across

the spectrum to experiment with new approaches and solutions. This report focuses on one area of

relatively new and promising approaches—those that elevate the talent and expertise of individuals with

“lived experience” with the justice system. Support for lived experience approaches is growing both

nationally and in San Diego. Beyond the rising number of lived experience initiatives, this type of work in

San Diego has become largely normalized. There is broad agreement that lived experience work should

be part of the portfolio used to reduce recidivism, with clear demand from stakeholders involved in

reentry, including law enforcement officials, service providers, community members, and, crucially,

justice-involved individuals. Given the growing prevalence of and support for lived experience approaches

in San Diego, it is important to create a deeper understanding of how to increase the impact of these

approaches. Toward that end, this report identifies strengths of lived experience approaches to amplify,

challenges of lived experience approaches to mitigate, and lessons from lived experience approaches

that can be applied more broadly. Based on a review of the research and dozens of conversations held

with stakeholders in San Diego, we identified the following strengths of lived experience app roaches: —

They can engage successfully with justice-involved individuals; — They can provide a model of success;

— They are skilled navigators of the social service and justice systems; — They bring a long-term

approach to their work; and — They have specific expertise that helps them help others. To amplify these

strengths, we suggest: (a) deploy lived experience practitioners during acute situations, (b) leverage lived

experience practitioners not only within programs but also as navigators across programs, (c) build

flexibility into programs that include lived experience practitioners, (d) encourage lived experience

practitioners to role model success without being directive, and (e) continue efforts to normalize lived

experience approaches. We also identified challenges of lived experience approaches, particularly

related to scaling the approaches more widely. These include: — The personalistic nature of many lived

experience initiatives; — The difficulty of finding, vetting, hiring, and training sufficient lived experience

practitioners; — The toll the immersive nature of the work takes on practitioners; and — The potential

reputational risks lived experience approaches present to individuals, organizations, and agencies. To

mitigate these challenges, we recommend (a) creating training and certification programs for lived

experience practitioners, (b) developing standards of practice, (c) creating organizational capacity -

building initiatives for lived experience organizations, (d) pairing lived experience with non-lived-

experience practitioners, (e) treating lived experience individuals as professional staff, and (f) developing

a lived experience advocacy coalition. Furthermore, seeking a broader impact, we identified five key

lessons from lived experience approaches that are transferable and can be applied by those without lived

experience who are designing and implementing initiatives to prevent recidivism. The lessons are: 1.

Create supportive spaces for justice-involved individuals to work through challenges; 2. Design programs

with flexibility so support can be tailored to individuals; 3. Ease navigation of services and improve

coordination among providers; 4. Engage justice-involved individuals with consistency and long-term

vision; and 5. Commit to providing trauma-informed care. We conclude this report by noting the

longstanding good practice in the social services field to design initiatives with the input of those impacted

by them. The key lessons identified from lived experience practitioners can be viewed in this way. They

provide insight on how to design more effective recidivism reduction initiatives based on the experience

and expertise of those who previously lived the challenges the initiatives are designed to address.

San Diego: University of San Diego, Kroc School Institute for Peace and Justice, 2023. 31p..

By Marco Castillo, Sera Linardi, Ragan Petrie:

Many previously incarcerated individuals are rearrested following release from prison. We investigate whether encouragement to use reentry support services reduces rearrest. Field experiment participants are offered a monetary incentive to complete different dosages of visits, either three or five, to a support service provider. The incentive groups increased visits, and one extra visit reduces rearrests three years after study enrollment by six percentage points. The results are driven by Black participants who are more likely to take up treatment and benefit the most from visits. The study speaks to the importance of considering first-stage heterogeneity and heterogeneous treatment effects.

IZA DP No. 17522

Bonn: IZA – Institute of Labor Economics, 2024. 46p.

By Ashley Nellis, and Celeste Barry.

In the United States, the federal government and every state enforces sentencing laws that incarcerate people for lengths that will exceed, or likely exceed, the span of a person’s natural life. In 2024, almost 200,000 people, or one in six people in prison, were serving life sentences. The criminal legal system’s dependence on life sentences disregards research showing that extreme sentences are not an effective public safety solution.

This report represents The Sentencing Project’s sixth national census of people serving life sentences, which includes life with the possibility of parole; life without the possibility of parole; and virtual life sentences (sentences reaching 50 years or longer). The report finds more people were serving life without parole (LWOP) in 2024 than ever before: 56,245 people were serving this “death by incarceration” sentence, a 68% increase since 2003. While the total number of people serving life sentences decreased 4% from 2020 to 2024, this decline trails the 13% downsizing of the total prison population. Moreover, nearly half the states had more people serving a life sentence in 2024 than in 2020. The large number of people serving life sentences raises critical questions about moral, financial, and justice-related consequences that must be addressed by the nation as well as the states. We believe the findings and recommendations documented in this report will contribute to better criminal legal policy decisions and a more humane and effective criminal legal system. KEY NATIONAL FINDINGS • One in six people in U.S. prisons is serving a life sentence (16% of the prison population, or 194,803 people)—a proportion that has reached an all-time high even as crime rates are near record lows. • The United States makes up roughly 4% of the world population but holds an estimated 40% of the world’s life-sentenced population, including 83% of persons serving LWOP. • More people are serving life without parole in 2024 than ever: 56,245 people, a 68% increase since 2003. • Despite a 13% decline in the total reported prison population from 2020 to 2024, the total number of people serving life sentences decreased by only 4%. • Nearly half of people serving life sentences are Black, and racial disparities are the greatest with respect to people sentenced

to life without parole. • A total of 97,160 people are serving sentences of life with parole. • Life sentences reaching 50 years or more, referred to as “virtual life sentences,” account for 41,398 people in prison. • Persons aged 55 and older account for nearly two-fifths of people serving life. • One in every 11 women in prison is serving a life sentence. • Almost 70,000 individuals serving life were under 25—youth and “emerging adults”—at the time of their offense. Among these, nearly one-third have no opportunity for parole. • Racial disparities in life imprisonment are higher among those who were under 25 at the time of their offense compared to those who were 25 and older.

Washington, DC: The Sentencing Project, 2025. 38p.

By Torbjørn Lien Kjær, Peter Hindersson, Jacob Rong Bentzen, Hanne Høegh Rasmussen, Torben Breindahl

Background

Drug use in Danish prisons has previously not been investigated in detail using confirmatory, laboratory analysis. The objective of the present quality study, initiated by the Danish Prison and Probation Service, was to i) evaluate the performance of an initial, on-site drug screening strategy; ii) gain insights into emerging drug trends; and iii) suggest evidence-based strategies for future drug testing.

Methods

Over a two-year period, routine urine samples (n = 1952 from 710 inmates) from three Danish prisons were subjected to comprehensive drug testing. Immunoassay screening was conducted on-site. A parallel sample aliquot was forwarded to laboratory analysis by confirmatory methods: High-performance liquid chromatography and tandem mass spectrometry (LC-MS/MS) and gas chromatography and mass spectrometry (GC-MS) targeting 56 drugs-of-abuse/medical drugs, 26 key metabolites, 41 new psychoactive substances (NPS), including specific biomarkers for heroin, crack cocaine, or ethanol (a total of 123 target analytes/sample).

Results

The on-site immunoassay method showed a sensitivity from 66 to 100%; specificity was above 98%; accuracy was above 95%. Laboratory analysis detected compounds not screened for including tramadol, oxycodone, buprenorphine, ketamine, MDMA, 4-fluoroamphetamine, and GHB. The prevalence of drug use was in the order: cannabis > ethanol > cocaine > benzodiazepines > amphetamine.

Conclusion

The performance of the immunoassay was found acceptable; however, the screening program was inadequate for detecting other significant substances. Based on these findings, a broader screening method will be implemented in future at Danish Prisons to minimize false negative results. The data did not indicate a trend of using NPS in Danish prisons.

Substance Use & Misuse Volume 60, 2025 - Issue 2

By Melissa Serafin, Julie Atella, Piere Washington, Sophak Mom

Reentry and community context Within three years of release from state prisons, federal prisons, and local jails, about half of people are reincarcerated and two-thirds are rearrested (Office of the Assistance Secretary for Planning and Evaluation, n.d.). Existing research highlights how challenges to reentry are compounded in rural communities because they are often underserved and under-resourced. Employment, housing, transportation, and limited social and health services are all common barriers for individuals reentering rural communities, and access to reentry programming is often limited (Benavides et al., 2023; Ward et al., 2016; Ward, 2017; Zajac et al., 2014). Additionally, the opioid crisis has significantly impacted rural communities, including those in Maine (Maine Governor’s Office of Policy Innovation and the Future, 2023). The rate of overdose fatalities in Maine increased from 0.3 per 1,000 population in January 2017 to 0.6 in January 2022, and the rate in Waldo County also increased from 0.2 in 2017 (8 total) to 0.5 in 2022 (20 total; Maine Drug Data Hub, 2024). Overdose fatalities most notably increased during the COVID-19 pandemic: the fatality rate in Maine increased 33% between 2019 and 2020, with 83% of deaths in 2020 due to opioids. Without opportunities, resources, and support, people reentering rural communities may experience hopelessness and criminogenic needs contributing to recidivism (Ward, 2017; Pettus-Davis & Kennedy, 2019). The findings from the current project also identified many of these challenges. Limited access to and availability of resources and services like internet, public transportation, health care and insurance, employment options, and affordable housing across counties and the state were stressed as barriers hindering the success of the program. Housing was identified as a particularly significant challenge, and this is compounded by the lack of viable employment options that provide a livable wage. The median cost for a studio efficiency or one-bedroom apartment in Waldo County, Maine in 2023 was $916-$922, and a two bedroom was $1,174 per month (RentData, 2024). According to the Maine Department of Labor (2024), the minimum wage in 2023 was $13.80 per hour in the state. Individuals employed full time, earning minimum wage, and who rent at least a studio efficiency would then be considered “cost-burdened”1 or “severely cost-burdened”2 (Office of Housing and Urban Development, 2014). Rent burden contributes to lacking the means to afford other necessities such as food, clothing, child care and more. Furthermore, the National Low Income Housing Coalition (NLIHC, 2024) notes the extreme shortage of rentals that are affordable to households whose incomes are at or below the poverty guideline or 30% of their area median income. In addition to the shortage of affordable housing and within the vicinity of the VOANNE network—within a four-city radius—there were no homeless shelters, nor mental health facilities with detox beds, and only one sober house. While VOANNE provides tents and camp supplies in more dire cases, and connects some participants with temporary transitional housing (including motels), they have access to very few permanent housing supports. Experiencing housing insecurity and homelessness can also negatively impact substance use. For example, efforts to stay awake to protect belongings and avoid violence is associated with developing and worsening substance use disorders (Mehtani et al., 2023). Existing research and findings from the current evaluation indicate that transportation is often a significant challenge for individuals reentering rural communities (Benavides et al., 2023; Ward, 2017; Zajac et al., 2014). While Maine does have some public transportation, rural areas have limited public transportation. Some communities have fixed route bus services that do not operate 24 hours a day and seven days a week, but these may only be in some counties (Eichacker, 2021). Limited public transportation means limited independence upon reentry to get to and from places like the DMV, a job interview, or to work. Additionally, some participants in the current evaluation did not possess driver’s licenses, further limiting their transportation options. This evaluation also identified how lack of phone service and high-speed internet make communication difficult and pose a barrier to building independence and integrating into society. Previous research has also identified these as significant reentry barriers (PettusDavis et al., 2019). Correctional system initiatives In response to the challenges that individuals face while reentering their communities, VOANNE and their partners have implemented several initiatives. Specifically, VOANNE has prioritized building trusting and collaborative partnerships with law enforcement agencies; this evaluation identified the strength of these partnerships. These partnerships facilitate opportunities to strengthen impact, such as the ability to provide services and programming within county jails while individuals are incarcerated. Additionally, postrelease offices and community spaces provide critical support to individuals who are reentering their communities after incarceration, and VOA’s diversion programming allows VOANNE to serve anyone who could benefit from services (e.g., not just individuals who are or have been incarcerated). VOANNE has also been able to expand to providing services in additional counties and correctional facilities over time.

St. Paul, MN: Wilder Research, 2024. 43p.

By Tom Jackson, Rachel Crorken, Sheenik Mills, and Carla Ayrton

This report presents findings from a one-year process evaluation that explored the delivery of unpaid work in England and Wales. The qualitative research design included a total of 102 interviews with: people on probation (25), beneficiaries (6), probation staff (62), and members of the judiciary (9); six focus groups with unpaid work staff; and ethnographic observations of 18 unpaid work projects. The evaluation was designed to assess what works in the delivery of unpaid work following the unification of the probation service and the £93 million investment to aid unpaid work delivery following the Covid-19 pandemic. The main findings from the evaluation are: Identity and purpose of unpaid work • All staff interviewed, believed the purpose of unpaid work is first and foremost a punishment, but it must also have elements of reparation in which people on probation give back to the community. Overall, staff were confident that unpaid work was meeting its aims as a punishment, which they viewed as the time people on probation give up attending their order. Staff also thought that unpaid work met reparative aims by ensuring that work carried out benefits the wider community. • Perceptions on whether unpaid work is rehabilitative were mixed. Staff explained how unpaid work can be rehabilitative for some individuals by providing an opportunity to learn ‘soft’ and practical skills. However, the rehabilitative potential of unpaid work was not applicable to everyone and was dependent on employment status, the type of project, and the individual’s willingness to engage with rehabilitative efforts. People on probation’s experience of unpaid work • People on probation identified relationships with supervisors as an important factor that affected their experience of unpaid work. A good relationship with a supervisor could encourage them to return and attend projects led by the same supervisor. Meaningful projects could increase compliance by encouraging people on probation to return to projects they believed had value. These were usually described as projects that would have benefits for the local community, and/or where people on probation had the opportunity to learn new skills, particularly if they thought these could lead to employment. • Many people on probation brought up communication issues they had with probation practitioners. These communication issues could make completing hours of unpaid work difficult either because their unpaid work hours were not set up in time or because people on probation could not contact probation to discuss issues they had with attending projects, making it hard to rearrange hours. • Many people on probation who were interviewed felt that wearing high-visibility vests, with unpaid work branding, caused them to experience unnecessary stigma and shame which could have negative impacts on their mental health. People on probation and supervisors thought, in particularly public areas, having to wear the branded high-visibility vests could impact compliance

Ministry of Justice Analytical Series

London: Ministry of Justice, 2024. 76p.

By Bowen Cho

In this report, we invite readers to explore the historical, racialized, disablist, and political economic contexts of mass incarceration, including the ways that incarceration has expanded beyond prisons, jails, and correctional supervision in the 21st century. As well, publics often think of incarceration narrowly, such that they make invisible the containment of Disabled people in institutional and extra-carceral systems. This report is in part a corrective and counterpoint to policy papers on disability and criminal legal reform published by non-disability advocacy and mental health advocacy organizations in recent years. Because the ideologies of eugenics, ableism, and disablism are thriving in the 21st century, disability is often used as a rhetorical frame arguing for the restriction of carceralism for certain groups and its expansion for others. Mass incarceration in the 21st century includes physical confinement, but also accounts for the rapidly expanding, technocratic industries of e-carceration and psychotropic incarceration. Our conceptions of physical confinement must go beyond prisons and jails, and include detention centers, psychiatric hospitals, nursing homes, and residential treatment facilities. One cannot replace the other. Recognition of incarcerated people must similarly be expanded to include detained immigrants, people under electronic monitoring and surveillance, and people experiencing involuntary psychiatric commitment. Black people and Indigenous people continue to be disproportionately impacted by policing and carceralism, particularly in the increased criminalization of poverty, houselessness, and mental illness, and the ways that these statuses intersect with racism and disablism.

Berkeley, CA: Disability Rights Education and Defense Fund (DREDF) , 2024. 120p.

By Pasangi S. Perera, Vanessa E. Miller,; Kate Vinita Fitch, et al

Since 2014, Medicaid expansion has been implemented in many states across the US, increasing health care access among vulnerable populations, including formerly incarcerated people who experience higher mortality rates than the general population. OBJECTIVE To examine population-level association of Medicaid expansion with postrelease mortality from all causes, unintentional drug overdoses, opioid overdoses, polydrug overdoses, suicides, and homicides among formerly incarcerated people in Rhode Island (RI), which expanded Medicaid, compared with North Carolina (NC), which did not expand Medicaid during the study period. DESIGN, SETTING, AND PARTICIPANTS A cohort study was conducted using incarceration release data from January 1, 2009, to December 31, 2018, linked to death records from January 1, 2009, to December 31, 2019, on individuals released from incarceration in RI and NC. Data analysis was performed from August 20, 2022, to February 15, 2024. Participants included those aged 18 years or older who were released from incarceration. Individuals who were temporarily held during ongoing judicial proceedings, died during incarceration, or not released from incarceration during the study period were excluded. EXPOSURE Full Medicaid expansion in RI effective January 1, 2014. MAIN OUTCOMES AND MEASURES Mortality from all causes, unintentional drug overdoses, unintentional opioid and polydrug overdoses, suicides, and homicides. RESULTS Between 2009 and 2018, 17 824 individuals were released from RI prisons (mean [SD] age, 38.39 [10.85] years; 31 512 [89.1%] male) and 160 861 were released from NC prisons (mean [SD] age, 38.28 [10.84] years; 209 021 [87.5%] male). Compared with NC, people who were formerly incarcerated in RI experienced a sustained decrease of 72 per 100 000 person-years (95% CI, −108 to −36 per 100 000 person-years) in all-cause mortality per quarter after Medicaid expansion. Similar decreases were observed in RI in drug overdose deaths (−172 per 100 000 person-years per 6 months; 95% CI, −226 to −117 per 100 000 person-years), including opioid and polydrug overdoses, and homicide deaths (−23 per 100 000 person-years per year; 95% CI, −50 to 4 per 100 000 person-years) after Medicaid expansion. Suicide mortality did not change after Medicaid expansion. After Medicaid expansion in RI, non-Hispanic White individuals experienced 3 times greater sustained decreases in all-cause mortality than all racially minoritized individuals combined, while non-Hispanic Black individuals did not experience any substantial benefits. There was no modification by sex. Individuals aged 30 years or older experienced greater all-cause mortality reduction after Medicaid expansion than those younger than 30 years.

JAMA Netw Open. 2024, 12 p.

By Nicholas Shapiro, Terence Keel

The rising number of jail deaths in the United States has left impacted community members, state actors, media, and scholars questioning if these rates are a reflection of the overall declining health of the nation or are due to factors specific to the carceral environment. This fact sheet contributes to this national dialogue through the analysis of autopsies for 58 deaths that occurred in Los Angeles County Jails over a 9-year period. Our study shows that young Black and Latinx men are not dying merely from "natural causes" but from the actions of jail deputies and carceral staff. Our findings support the efforts of community members and lawmakers attempting to reform the cash bail system in Los Angeles County as three quarters of the deaths in our study were individuals held in pre-trial detention. Moreover, our study supports the urgent need to reduce the jail population to expedite the closing of Men’s Central Jail and the potential life saving benefits of jail diversion programs for the people of Los Angeles County. We focus on autopsies because they are fundamental to establishing the causes and manner of death in carceral facilities that have limited public accountability. 

Los Angeles, UCLA Carceral Ecologies Lab, BioCritical Studies Lab, 2022. 9p.

By Carmen Johnson et al and the UCLA BioCritical Studies Lab

The BioCritical Studies Lab analyzed a sample of 180 deaths in 10 city and county detention centers in Maryland between 2008 and 2019. These detention centers are distinct from state correctional facilities in that they primarily confine persons who are awaiting trial or arraignment. Our study sample reflects only deaths self-reported by these 10 city and county detention centers to the Bureau of Justice Statistics (BJS) during this time period. Our sample represents only a portion of all in-custody deaths known to have taken place throughout Maryland during the study period. Our analysis produced five key findings: - First, the detention centers with the most instances of in-custody death in our study sample are situated in jurisdictions with both high rates of poverty and large numbers of Black residents. The confluence of these two factors is strongly correlated to in-custody death. - Second, the average age of in-custody deaths officially designated as “natural” is substantially lower than life expectancy among the non-jailed population, possibly indicating the widespread misclassification of deaths attributable to violence and/or negligence as “natural” by the Maryland Office of the Chief Medical Examiner. - Third, over 80% of the deaths in our sample took place while the decedent was awaiting trial, meaning they had not been convicted of any crime at the time of death. - Fourth, about half of the decedents included in our sample died within 10 days of their admission to the detention center, and more than one sixth died less than two days after their admission, suggesting that even short stays in detention present a significant risk of premature death. - And fifth, there currently exist high barriers preventing public access to key information regarding deaths in Maryland detention centers that place comprehensive study of this social problem out of reach. We conclude by making several recommendations as to how policymakers might address the problems described in this report, including systematically reducing jail populations through the elimination of pretrial detention, establishing an explicit mandate for the Office of the Chief Medical Examiner to investigate all instances of in-custody death, and codifying new standards for publicly reporting information about in-custody deaths when they occur.  

Los Angeles; BioCritical Studies Lab, Institute for Society and Genetics, University of California – Los Angeles.  2023. 26p.

By David Olson, Don Stemen, & Patrick Griffin 

Loyola University Chicago’s Center for Criminal Justice, through the support of the John D. and Catherine T. MacArthur Foundation, collaborated with the Illinois Department of Corrections’ Planning and Research Unit to examine the number, characteristics, and circumstances of individuals on Mandatory Supervised Release (MSR, or “parole”) who violated conditions of their release and were returned to prison (i.e., “technical violators”). Over the past two decades, between 20% and 30% of all admissions to the Illinois Department of Corrections (IDOC) have been individuals returned to prison as MSR technical violators. Given the substantial impact of these technical violations on overall prison admissions in Illinois, this report examines the characteristics and circumstances that led to those returns to prison during state fiscal year (SFY) 2020 (July 2019 through June 2020). Specifically, the Loyola team analyzed detailed information for all those returned to prison due to technical MSR violations during SFY 2020 (N=5,052), and compared it to findings from similar research that was conducted with a one-month sample of technical MSR violator admissions in 2010 (see https://spac.illinois.gov/publications/researchreports/msr-violators). What Did We Find? 1) The rate of technical violation admissions to IDOC has been relatively stable over the past decade, whether measured as a percent of admissions or as a percent of IDOC exits returned to prison within 3 years of release. Over the past two decades, technical violators have accounted for somewhere between 20% and 30% of all admissions to prison; similarly, between 20% and 30% of all of those returned to prison within 3 years of their release during this period have been returned as technical violators. 2) Although technical violators account for 20% to 30% of all admissions to IDOC, they tend to stay in prison for a shorter period of time than court-sentenced individuals. Over the past two decades they have accounted for a smaller proportion - between 7% and 12% - of the IDOC population. 3) Although the proportion of admissions accounted for by technical violators has remained relatively consistent over the past decade, the number of admissions for technical violations has decreased, consistent with the overall decrease in admissions to prison. During the 10-year period from 2010 to 2019 (pre-COVID), total admissions to prison fell 39%, with a 38% decrease seen in admissions for technical violations and a 40% decrease in court sentences. 4) Although previous research found wide fluctuations from month to month in the number of technical violators returned to prison during the 2001 to 2011 period, often due to politically-driven crackdowns, the only substantial change in admissions during the past decade occurred when COVID-19 dramatically reduced arrests and admissions to prison in Illinois. 5) Of those individuals returned to prison due to technical violations in SFY 2020, most (58%) were returned, at least in part, because of an arrest while on MSR, often for a violent crime or firearm possession offense. 6) One out of every 5 people (20%) “returned” to prison for technical violations in SFY 2020 did not have an approved place to live, and so were not in fact released at all (referred to as “gate violators” by IDOC). Most (84%) of those returned as gate violators had been serving prison sentences for sex offenses, a population that historically has challenges finding approved housing upon release from prison. 7) COVID-19 dramatically reduced the number of admissions to IDOC for technical violations and resulted in a shift in the nature of technical violations that resulted in admission to prison. While the percent of prison admissions accounted for by technical violations did not change between SFY 2011 and the portion of SFY 2020 that preceded the beginning of the COVID-19 pandemic, a smaller portion of those admitted in the pre-COVID part of SFY 2020 were for non-arrest violations and a larger share of admissions involved new arrest charge(s), particularly for violent and firearm possession offenses. 

Loyola Chicago Center for Criminal Justice, 2023. 11p.