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Zhao X, Hingle A, Shaw CC, Murphy A, Riddick BR, Davidson Mhonde RR, Taylor BG, Lamuda PA, Pollack HA, Schneider JA, Taxman FS. Endorsement of COVID-19 misinformation among criminal legal involved individuals in the United States: Prevalence and relationship with information sources. PLoS One 2024; 19:e0296752. [PMID: 38181012 PMCID: PMC10769018 DOI: 10.1371/journal.pone.0296752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/14/2023] [Indexed: 01/07/2024] Open
Abstract
Criminal legal system involvement (CLI) is a critical social determinant of health that lies at the intersection of multiple sources of health disparities. The COVID-19 pandemic exacerbates many of these disparities, and specific vulnerabilities faced by the CLI population. This study investigated the prevalence of COVID-19-related misinformation, as well as its relationship with COVID-19 information sources used among Americans experiencing CLI. A nationally representative sample of American adults aged 18+ (N = 1,161), including a subsample of CLI individuals (n = 168), were surveyed in February-March 2021. On a 10-item test, CLI participants endorsed a greater number of misinformation statements (M = 1.88 vs. 1.27) than non-CLI participants, p < .001. CLI participants reported less use of government and scientific sources (p = .017) and less use of personal sources (p = .003) for COVID-19 information than non-CLI participants. Poisson models showed that use of government and scientific sources was negatively associated with misinformation endorsement for non-CLI participants (IRR = .841, p < .001), but not for CLI participants (IRR = .957, p = .619). These findings suggest that building and leveraging trust in important information sources are critical to the containment and mitigation of COVID-19-related misinformation in the CLI population.
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Affiliation(s)
- Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, Virginia, United States of America
| | - Aayushi Hingle
- Department of ELAP, Linguistics, & Communication Studies, Montgomery College, Takoma Park, Maryland, United States of America
| | - Cameron C. Shaw
- Schar School of Public Policy, George Mason University, Fairfax, Virginia, United States of America
| | - Amy Murphy
- Schar School of Public Policy, George Mason University, Fairfax, Virginia, United States of America
| | - Breonna R. Riddick
- Department of Communication, George Mason University, Fairfax, Virginia, United States of America
| | | | - Bruce G. Taylor
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Phoebe A. Lamuda
- NORC at the University of Chicago, Chicago, Illinois, United States of America
| | - Harold A. Pollack
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois, United States of America
| | - John A. Schneider
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Faye S. Taxman
- Schar School of Public Policy, George Mason University, Fairfax, Virginia, United States of America
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Watson TM, Benassi PV, Agic B, Maharaj A, Sockalingam S. Community-Based Mental Health and Substance Use Services for People Leaving Prison: Equity and Inclusion Strengths and Limitations in Specialized Service Inventory Development. Community Ment Health J 2023; 59:421-427. [PMID: 36380033 PMCID: PMC9667000 DOI: 10.1007/s10597-022-01050-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community reentry from prison is a challenging process, especially for persons with lived and living experience of mental health concerns. Access to appropriate community-based care for those leaving prison is a key part of improving health equity for this population. Our work to develop a cross-Canada inventory of active community mental health and substance use services for criminal justice-involved persons represents a valuable example for others hoping to conduct projects that are similar in nature and scope. We describe the strengths and limitations of our health equity-informed, multi-pronged approach to service inventory development, highlighting the importance of considering and addressing search- and stakeholder-related biases. Investment of time and resources is critical to ensuring comprehensive and inclusive identification of community-based mental health services and meaningful resource development.
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Affiliation(s)
- Tara Marie Watson
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada.
- Provincial System Support Program, CAMH, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
| | - Paul Victor Benassi
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Asha Maharaj
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
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Bono MH, Treitler P, Saloner B, Crystal S. Returning home during the pandemic: a thematic analysis describing experiences of people with substance use disorders released early from New Jersey prisons during COVID-19. HEALTH & JUSTICE 2023; 11:11. [PMID: 36847934 PMCID: PMC9969013 DOI: 10.1186/s40352-023-00208-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND & AIMS The COVID-19 pandemic created intersecting health risks for incarcerated people with a history of substance use disorder (SUD). To reduce exposure to COVID-19 in prison, several US states enacted decarceration legislation. New Jersey enacted the Public Health Emergency Credit Act (PHECA), granting early release to thousands of incarcerated persons meeting eligibility criteria. This study undertook to explore how large scale decarceration during the pandemic impacted the reentry process for released individuals with SUDs. METHODS Twenty seven participants involved in PHECA releases - 21 persons released from NJ carceral facilities with past/present SUDs (14 with opioid use disorder, 7 with other SUDs) and 6 reentry service providers acting as key informants - completed phone interviews on PHECA experiences from February-June 2021. Cross-case thematic analysis of transcripts identified common themes and divergent perspectives. RESULTS Respondents described challenges consistent with long-documented reentry difficulties including housing and food insecurity, difficulty accessing community services, insufficient employment opportunities, and limited access to transportation. Challenges that were pertinent to mass release during a pandemic included limited access to communication technology and community providers and community providers exceeding enrollment capacity. Despite reentry difficulties, respondents identified many areas where prisons and reentry service providers adapted to meet novel challenges presented by mass decarceration during the COVID-19 pandemic. Facilitators made available by prison and reentry provider staff included providing released persons with cell phones, transportation assistance at transit hubs, prescription support for medications for opioid use disorder, and pre-release assistance with ID and benefits through NJ's Joint Comprehensive Assessment Plan. CONCLUSIONS Formerly incarcerated people with SUDs experienced reentry challenges during PHECA releases similar to those that occur during ordinary circumstances. Despite barriers faced during typical releases and novel challenges unique to mass release during a pandemic, providers made adaptations to support released persons' successful reentry. Recommendations are made based on areas of need identified in interviews, including reentry service provision facilitating housing and food security, employment, medical services, technology fluency, and transportation. In anticipation of future large scale releases, providers will benefit from planning ahead and adapting to address temporary increases in resource demands.
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Affiliation(s)
- Madeline H Bono
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, 152 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA.
| | - Peter Treitler
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
| | - Brendan Saloner
- Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephen Crystal
- Center for Health Services Research, Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
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Saunders EC, Satcher MF, Monico LB, McDonald RD, Springer SA, Farabee D, Gryczynski J, Nyaku A, Reeves D, Kunkel LE, Schultheis AM, Schwartz RP, Lee JD, Marsch LA, Waddell EN. The impact of COVID-19 on the treatment of opioid use disorder in carceral facilities: a cross-sectional study. HEALTH & JUSTICE 2022; 10:35. [PMID: 36529829 PMCID: PMC9760540 DOI: 10.1186/s40352-022-00199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs. Naltrexone Opioid Treatments in Criminal Justice System-Involved Adults (EXIT-CJS) study. In December 2020, carceral sites (n = 6; median pre-COVID 2020 monthly census = 3468 people) and CTPs (n = 7; median pre-COVID 2020 monthly census = 550 patients) participating in EXIT-CJS completed a cross-sectional web-based survey. The survey assessed changes pre- (January-March 2020) and post- (April-September 2020) COVID-19 in OUD treatment, telemedicine use, re-entry supports and referral practices. Compared to January-March 2020, half of carceral sites (n = 3) increased the total number of persons initiating medication for opioid use disorder (MOUD) from April-September 2020, while a third (n = 2) decreased the number of persons initiated. Most CTPs (n = 4) reported a decrease in the number of new admissions from April-September 2020, with two programs stopping or pausing MOUD programs due to COVID-19. All carceral sites with pre-COVID telemedicine use (n = 5) increased or maintained telemedicine use, and all CTPs providing MOUD (n = 6) increased telemedicine use. While expansion of telemedicine services supported MOUD service delivery, the majority of sites experienced challenges providing community support post-release, including referrals to housing, employment, and transportation services. During the COVID-19 pandemic, this small sample of carceral and CTP sites innovated to continue delivery of treatment for OUD. Expansion of telemedicine services was critical to support MOUD service delivery. Despite these innovations, sites experienced challenges providing reintegration supports for persons in the community. Pre-COVID strategies for identifying and engaging individuals while incarcerated may be less effective since the pandemic. In addition to expanding research on the most effective telemedicine practices for carceral settings, research exploring strategies to expand housing and employment support during reintegration are critical.
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Affiliation(s)
- Elizabeth C Saunders
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA.
| | - Milan F Satcher
- Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Ryan D McDonald
- New York University Grossman School of Medicine, New York, NY, USA
| | - Sandra A Springer
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - David Farabee
- New York University Grossman School of Medicine, New York, NY, USA
| | | | - Amesika Nyaku
- Division of Infectious Diseases, Rutgers New Jersey Medical School, New Brunswick, NJ, USA
| | - Donald Reeves
- Rutgers University Correctional Health Care, Rutgers-Robert Wood Johnson Medical School, Trenton, NJ, USA
| | - Lynn E Kunkel
- Oregon Health and Science University -Portland State University School of Public Health and Addiction Medicine Section, Division of General Internal Medicine & Geriatrics, Oregon Health and Science University, Portland, OR, USA
| | - Alysse M Schultheis
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | | | - Joshua D Lee
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA
| | - Elizabeth Needham Waddell
- Oregon Health and Science University -Portland State University School of Public Health and Addiction Medicine Section, Division of General Internal Medicine & Geriatrics, Oregon Health and Science University, Portland, OR, USA
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Porter NAC, Brosnan HK, Chang AH, Henwood BF, Kuhn R. Race and Ethnicity and Sex Variation in COVID-19 Mortality Risks Among Adults Experiencing Homelessness in Los Angeles County, California. JAMA Netw Open 2022; 5:e2245263. [PMID: 36472872 PMCID: PMC9856229 DOI: 10.1001/jamanetworkopen.2022.45263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/20/2022] [Indexed: 12/12/2022] Open
Abstract
Importance Few studies have used precise age-specific data to construct age-standardized estimates of the relative risks (RRs) of COVID-19 mortality for people experiencing homelessness (PEH) vs the general population, and none to date has addressed race and ethnicity and sex variations in COVID-19 mortality among PEH with COVID-19 infection. Objective To measure age-standardized mortality rate ratios for PEH vs the general population overall and by sex and race and ethnicity. Design, Setting, and Participants In this cross-sectional study, crude and age-specific COVID-19 mortality rates per 100 000 people were calculated using 5-year age groups and standardized mortality ratios for PEH and the general population aged 25 years and older, assessing differences by race and ethnicity and sex, from January 1, 2020, to November 1, 2021. Mortality and population estimates came from COVID-19 mandatory case reporting conducted by the Los Angeles County Department of Public Health, the annual point-in-time homeless count, and the US Census. Main Outcomes and Measures The main outcome was COVID-19 deaths sourced from clinician reports, death certificates, medical examiner reports, and vital records deaths. PEH status was determined using the US Department of Housing and Urban Development definitions for homelessness at the time of COVID-19 diagnosis or symptom onset. Results The study population included 25 441 deaths among an estimated 6 382 402 general population individuals and 256 deaths among an estimated 52 015 PEH. The race and ethnicity of the PEH sample was as follows: 15 539 Black (29.9%), 18 057 Hispanic (34.7%), 14 871 female (28.6%), 37 007 male (71.3%), and 3380 aged 65 years or older (6.5%), compared with the estimated general population of 6 382 402, which was 591 003 Black (9.3%), 2 854 842 Hispanic (44.7%), 3 329 765 female (52.2%), 3 052 637 male (47.8%), and 1 190 979 aged 65 years or older (18.7%). Crude death rates were 0.49% for PEH and 0.40% for the general population, but PEH experienced age-specific COVID-19 mortality risk 2.35 (95% CI, 2.08-2.66) times higher than the general population. There was significant risk associated with PEH status compared with their counterparts in the general population for Black PEH (RR, 1.69; 95% CI, 1.31-2.18), Hispanic PEH (RR, 2.34; 95% CI, 1.96-2.79), White PEH (RR, 8.33; 95% CI, 6.37-10.88), female PEH (RR, 3.39; 95% CI, 2.56-4.48), and male PEH (RR, 1.74; 95% CI, 1.52-2.00). Conclusions and Relevance This cross-sectional study of COVID-19 mortality among PEH with COVID-19 infection provides evidence suggesting excess risk of age-adjusted COVID-19 mortality among PEH compared with the general population. This study furthers understanding of the intersectional association between homelessness and race and ethnicity, as higher levels of mortality but narrower racial disparities among PEH than in the general population were observed.
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Affiliation(s)
- Natalie A. C. Porter
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | | | - Alicia H. Chang
- Los Angeles Department of Public Health, Los Angeles, California
| | - Benjamin F. Henwood
- Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Randall Kuhn
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
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Flam-Ross JM, Lown J, Patil P, White LF, Wang J, Perry A, Bailer D, McKenzie M, Thigpen A, Newman R, Lincoln M, Mckinney T, Bernson D, Barocas JA. Factors associated with opioid-involved overdose among previously incarcerated people in the U.S.: A community engaged narrative review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103534. [PMID: 34896932 PMCID: PMC8810696 DOI: 10.1016/j.drugpo.2021.103534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND People with a history of incarceration are at high risk for opioid overdose. A variety of factors contribute to this elevated risk though our understanding of these factors is deficient. Research to identify risk and protective factors for overdose is often conducted using administrative data or researcher-derived surveys and without explicit input from people with lived experience. We aimed to understand the scope of U.S. research on factors associated with opioid overdose among previously incarcerated people. We did this by conducting a narrative review of the literature and convening expert panels of people with lived experience. We then categorized these factors using a social determinants of health framework to help contextualize our findings. METHODS We first conducted a narrative review of the published literature. A search was performed using PubMed and APA PsycInfo. We then convened two expert panels consisting of people with lived experience and people who work with people who were previously incarcerated. Experts were asked to evaluate the literature derived factors for completeness and add factors that were not identified. Finally, we categorized factors as either intermediary or structural according to the World Health Organization's Social Determinants of Health (SDOH) Framework. RESULTS We identified 13 papers that met our inclusion criteria for the narrative review. Within these 13 papers, we identified 22 relevant factors for their role in the relationship between overdose and people with a history of incarceration, 16 were risk factors and six were protective factors. Five of these were structural factors (three risk and two protective) and 17 were intermediary factors (13 risk and four protective). The expert panels identified 21 additional factors, 10 of which were structural (six risk and four protective) and 11 of which were intermediary (eight risk and three protective). CONCLUSION This narrative review along with expert panels demonstrates a gap in the published literature regarding factors associated with overdose among people who were previously incarcerated. Additionally, this review highlights a substantial gap with regard to the types of factors that are typically identified. Incorporating voices of people with lived experience is crucial to our understanding of overdose in this at-risk population.
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Affiliation(s)
| | - Josh Lown
- Boston College School of Social Work (BCSSW)
| | - Prasad Patil
- Boston University School of Public Health, Department of Biostatistics
| | - Laura F. White
- Boston University School of Public Health, Department of Biostatistics
| | - Jianing Wang
- Boston University School of Public Health, Department of Biostatistics
| | | | | | | | | | | | - Meko Lincoln
- Rhode Island Hospital COBRE on Opioids and Overdose
| | | | | | - Joshua A. Barocas
- University of Colorado Anschutz Medical Campus, Divisions of General Internal Medicine and Infectious Diseases,Corresponding author: Joshua A. Barocas, MD, University of Colorado School of Medicine, 8th Floor, Academic Office 1, Mailstop B180, 12631 E 17th Ave, Aurora, CO 80045, +1-314-348-3278,
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7
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Chen Q, Sterner G, Segel J, Feng Z. Trends in opioid-related crime incidents and comparison with opioid overdose outcomes in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 101:103555. [PMID: 35026674 DOI: 10.1016/j.drugpo.2021.103555] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/15/2021] [Accepted: 11/28/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The opioid epidemic in the United States remains a critically important public health issue and continues to worsen. While healthcare data and outcomes are commonly used to characterize the state of the epidemic and evaluate the impact of policy changes, criminal justice data is under-utilized in research despite its high relevance and unique role in the opioid crisis. Our objective is to understand temporal trends in opioid-related crime incidents and the comparability with the dynamic patterns in health-related outcomes. METHODS We used incident-level crime data from the National Incident-Based Reporting System (NIBRS) during 2005-2018. We identified all incidents involving opioids, which were grouped by opioid type (illicit and prescription opioids), and by drug-related criminal activity (possession and distribution). We estimated annual opioid-related crime incident rates per 100,000 residents. Joinpoint analysis was performed to examine the significant changes in the temporal trends of crime incident rates. We examined the association between opioid-related crime incidents and health outcomes using state fixed effects regression models. RESULTS Among the NIBRS covered population, incident rates of all opioid-related crimes increased significantly from 32.0 to 91.4 per 100,000 between 2005 and 2016, followed by a moderate decrease to 78.3 per 100,000 by 2018. The initial increase in incident rates was predominantly driven by prescription opioid-related incidents which increased by 19.6% per year from 2005 to 2010. Between 2010 and 2015, most of the increase came from illicit opioid-related incidents which accelerated to an increase of 21.6% per year. Opioid-related crime incident rates were found to be significantly and positively associated with rates of opioid-related emergency department visits, inpatient hospitalization, and overdose mortality. CONCLUSION Crime data describe temporal trends and shifting patterns in the opioid epidemic that are highly consistent with health-related data. Criminal justice data could be a potentially powerful tool to understand the changing landscape of opioid and substance use.
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Affiliation(s)
- Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA, USA.
| | - Glenn Sterner
- Criminal Justice Research Center and Department of Criminal Justice, The Pennsylvania State University Abington Campus, Abington, PA, USA
| | - Joel Segel
- Department of Health Policy and Administration, The Pennsylvania State University, University Park, PA, USA
| | - Zixuan Feng
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA, USA
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Watson TM, Benassi PV, Agic B, Maharaj A, Sockalingam S. Addressing the complex substance use and mental health needs of people leaving prison: Insights from developing a national inventory of services in Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 100:103523. [PMID: 34785421 DOI: 10.1016/j.drugpo.2021.103523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
Internationally, transitions from prison to the community are often precarious experiences for people who are living with substance use and mental health concerns. In Canada, a continuing opioid overdose crisis and overlapping challenges related to the COVID-19 pandemic have generated urgency for scaling up community-based services that can meet the complex substance use and mental health needs of people leaving prison. In this commentary, we reflect on our experience with and knowledge gained by developing a national inventory of substance use and mental health services for criminal justice-involved persons who are re-entering the community. We learned that there is a scarcity of such community-based services specific to criminal justice-involved populations and a glaring lack of information about culturally safe and appropriate supports. Stakeholders from organisations across Canada identified that communities need a comprehensive array of low-barrier services, inclusive of harm reduction and substance use treatment services, to meet the diverse needs of people leaving prison. We recommend building greater investment in and awareness of community-driven, local programs, as well as enhancing efforts to engage people with lived and living experience in service design and provision. We also briefly describe a few programs to highlight examples of how to operationalise the themes that we observed to emerge while developing a national inventory of community-based substance use and mental health services for criminal justice-involved persons.
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Affiliation(s)
- Tara Marie Watson
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada.
| | - Paul Victor Benassi
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Branka Agic
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
| | - Asha Maharaj
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada
| | - Sanjeev Sockalingam
- Centre for Addiction and Mental Health (CAMH), 1000 Queen Street West, Toronto, ON, M6J 1H4, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
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9
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Pearce LA, Vaisey A, Keen C, Calais-Ferreira L, Foulds JA, Young JT, Southalan L, Borschmann R, Gray R, Stürup-Toft S, Kinner SA. A rapid review of early guidance to prevent and control COVID-19 in custodial settings. HEALTH & JUSTICE 2021; 9:27. [PMID: 34652519 PMCID: PMC8518275 DOI: 10.1186/s40352-021-00150-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND With over 11 million people incarcerated globally, prevention and control of COVID-19 in custodial settings is a critical component of the public health response. Given the risk of rapid transmission in these settings, it is important to know what guidance existed for responding to COVID-19 in the early stages of the pandemic. We sought to identify, collate, and summarise guidance for the prevention and control of COVID-19 in custodial settings in the first six months of 2020. We conducted a systematic search of peer-reviewed and grey literature, and manually searched relevant websites to identify publications up to 30 June 2020 outlining recommendations to prevent and/or control COVID-19 in custodial settings. We inductively developed a coding framework and assessed recommendations using conventional content analysis. RESULTS We identified 201 eligible publications containing 374 unique recommendations across 19 domains including: preparedness; physical environments; case identification, screening, and management; communication; external access and visitation; psychological and emotional support; recreation, legal, and health service adaptation; decarceration; release and community reintegration; workforce logistics; surveillance and information sharing; independent monitoring; compensatory measures; lifting control measures; evaluation; and key populations/settings. We identified few conflicting recommendations. CONCLUSIONS The breadth of recommendations identified in this review reflects the complexity of COVID-19 response in custodial settings. Despite the availability of comprehensive guidance early in the pandemic, important gaps remain in the implementation of recommended prevention and control measures globally, and in the availability of evidence assessing their effectiveness on reducing COVID-19 disease, impact on people in custody and staff, and implementation.
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Affiliation(s)
- Lindsay A Pearce
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia.
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Alaina Vaisey
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
| | - Claire Keen
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
| | - Lucas Calais-Ferreira
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - James A Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jesse T Young
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Louise Southalan
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Law School, University of Western Australia, Perth, Western Australia, Australia
| | - Rohan Borschmann
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ruth Gray
- Healthcare in Prison, South Eastern Health and Social Care Trust, Belfast, North Ireland, UK
| | | | - Stuart A Kinner
- Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Abstract
The United States is experiencing an evolving and worsening drug overdose epidemic. Although the rate of drug use among workers has remained relatively stable, the risk of overdose and death among drug users has not, as illicit drugs have increased in potency and lethality. The cumulative impacts of COVID-19 and the opioid crisis increase the likelihood of illness and death among workers with opioid use disorder. Workplaces represent a critical point of contact for people living in the United States who are struggling with or recovering from a substance use disorder, and employment is a vital source of recovery "capital." The benefits of addressing substance use in the workplace, supporting treatment, and employing workers in recovery are evident. The National Institute for Occupational Safety and Health has published research to inform policy and practice toward prevention efforts and has developed accessible resources and toolkits to support workers, employers, and workplaces in combatting the opioid overdose crisis and creating safer, healthier communities.
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Affiliation(s)
- Jamie C Osborne
- National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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11
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Henry BF. Reducing COVID-19 outbreaks in prisons through public health-centred policies. LANCET PUBLIC HEALTH 2021; 6:e701-e702. [PMID: 34364403 PMCID: PMC8342315 DOI: 10.1016/s2468-2667(21)00183-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/15/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Brandy F Henry
- Columbia University School of Social Work, New York, NY, USA; The Pennsylvania State University College of Education, University Park, PA 16802, USA.
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12
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Showalter D, Wenger LD, Lambdin BH, Wheeler E, Binswanger I, Kral AH. Bridging institutional logics: Implementing naloxone distribution for people exiting jail in three California counties. Soc Sci Med 2021; 285:114293. [PMID: 34388622 DOI: 10.1016/j.socscimed.2021.114293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
Drug overdose is the leading cause of death among formerly incarcerated people. Distribution of the opioid overdose medication naloxone to people who use drugs reduces overdose mortality, and officials in many jurisdictions are now considering or implementing programs to offer naloxone to people exiting jails and prisons. The principles and practices of harm reduction programs such as naloxone distribution conflict with those of penal institutions, raising the question of how organizations based on opposing institutional logics can collaborate on lifesaving programs. Using in-depth interviews and observations conducted over four years with 34 penal, medical, public health, and harm reduction practitioners, we introduce and conceptualize two organizational features to explain why this therapeutic intervention was implemented in local jails in two of three California counties. First, interorganizational bridges between harm reduction, medical, and penal organizations facilitated mutual understanding and ongoing collaboration among administrators and frontline workers in different agencies. Second, respected and influential champions within public health and penal organizations put jail-based naloxone distribution on the local agenda and cultivated support among key officials. Our findings offer guidance for future studies of institutional logics and policy responses to the overdose crisis.
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Affiliation(s)
- David Showalter
- Sociology Department, University of California-Berkeley, 410 Social Sciences Building, Berkeley, CA, 94720-1980, USA.
| | - Lynn D Wenger
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
| | - Barrot H Lambdin
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
| | - Eliza Wheeler
- Homeless Youth Alliance, PO Box 170427, San Francisco, CA, 94117, USA
| | - Ingrid Binswanger
- Kaiser Permanente Colorado, Institute for Health Research, 2550 S. Parker Rd Suite 200, Aurora, CO, 80014, USA
| | - Alex H Kral
- RTI International, 2150 Shattuck Avenue Suite 800, Berkeley, CA, 94704, USA
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13
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Scott CK, Dennis ML, Grella CE, Mischel AF, Carnevale J. The impact of the opioid crisis on U.S. state prison systems. HEALTH & JUSTICE 2021; 9:17. [PMID: 34304335 PMCID: PMC8310396 DOI: 10.1186/s40352-021-00143-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/28/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Prior studies have documented limited use of medications to treat opioid use disorders (OUD) for people incarcerated within state prisons in the United States. Using the framework of the criminal justice OUD service cascade, this study interviewed representatives of prison systems in states most heavily impacted by opioid overdose regarding the provision of medications for OUD (MOUD). METHODS A stratified sampling strategy included states with high indicators of opioid-overdose deaths. Two sampling strata targeted states with: 1) OUD overdose rates significantly higher than the per capita national average; or 2) high absolute number of OUD overdose fatalities. Interviews were completed with representatives from 21 of the 23 (91%) targeted states in 2019, representing 583 prisons across these states. Interviews assessed service provision across the criminal justice OUD service cascade, including OUD screening, withdrawal management, MOUD availability and provision, overdose prevention, re-entry services, barriers, and needs for training and technical assistance. RESULTS MOUD (buprenorphine, methadone, or naltrexone) was available in at least one prison in approximately 90% of the state prison systems and all three medications were available in at least one prison in 62% of systems. However, MOUD provision was limited to subsets of prisons within these systems: 15% provided buprenorphine, 9% provided methadone, 36% provided naltrexone, and only 7% provided all three. Buprenorphine and methadone were most frequently provided to pregnant women or individuals already receiving these at admission, whereas naltrexone was primarily used at release. Funding was the most frequently cited barrier for all medications. CONCLUSION Study findings yield a complex picture of how, when, and to whom MOUD is provided across prisons within prison systems in states most heavily impacted by opioid overdose in the United States and have implications for expanding availability.
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Affiliation(s)
- Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | | | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
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14
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Supporting Persons Who Use Drugs During the COVID-19 Pandemic: A Rapid Review of International Guidelines. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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15
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Johnson L, Gutridge K, Parkes J, Roy A, Plugge E. Scoping review of mental health in prisons through the COVID-19 pandemic. BMJ Open 2021; 11:e046547. [PMID: 33986064 PMCID: PMC8727680 DOI: 10.1136/bmjopen-2020-046547] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/13/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff. DESIGN Scoping review. DATA SOURCES PubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies. ELIGIBILITY CRITERIA FOR SELECTION OF STUDIES All papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers. RESULTS Of 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons. CONCLUSIONS It is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.
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Affiliation(s)
- Luke Johnson
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
| | - Julie Parkes
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Anjana Roy
- Health and Justice Team, Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK
| | - Emma Plugge
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
- Health and Justice Team, Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK
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16
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Grunvald W, Herrington R, King R, Lamberson M, Mackey S, Maruti S, Rawson R, Wolfson D. COVID-19: A new barrier to treatment for opioid use disorder in the emergency department. J Am Coll Emerg Physicians Open 2021; 2:e12403. [PMID: 33748808 PMCID: PMC7967916 DOI: 10.1002/emp2.12403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/24/2021] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Start Treatment and Recover (STAR) is an emergency department (ED) program that expands access to medication for opioid use disorder by identifying patients with opioid use disorder and offering ED-initiated buprenorphine/naloxone and rapid access to outpatient treatment. We sought to determine the impacts of the coronavirus disease 2019 pandemic on STAR and the patients with opioid use disorder it serves. METHODS We conducted a retrospective review of records comparing 2 periods: pre-pandemic (February 1, 2019-February 29, 2020) and pandemic (March 1, 2020-May 31, 2020). Variables evaluated included the number of STAR enrollments, ED census, percentage of census screening positive for opioid use disorder, number and percentage of ED overdose visits, and overdose fatalities by month. All analyses were conducted using 2-sample t tests to calculate the mean and 95% confidence intervals (CIs). RESULTS Comparing the pre-pandemic to the pandemic period, the mean monthly ED visits decreased from 5126.9 to 3306.7 (difference = -1820.3; 95% CI, -3406.3 to -234.2), STAR mean monthly enrollments decreased from 9.7 to 1.3 (difference = -8.4; 95% CI, -12.8 to -4.0), and statewide monthly opioid-related fatalities increased from 9.4 to 15.3 (difference = 5.9; 95% CI, 0.8 to 11.1). However, the percentage of individuals who presented to the ED with opioid use disorder or overdose remained unchanged. CONCLUSION Although overall ED visits declined during the pandemic period, the percentage of patients presenting with opioid use disorder or overdose remained constant, yet there was a dramatic decline in enrollment in ED-initiated medication for opioid use disorder and an increase in statewide monthly opioid-related fatalities. Strategies to maintain medication for opioid use disorder treatment options must be implemented for this vulnerable population during the ongoing pandemic.
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Affiliation(s)
- Warren Grunvald
- University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Ramsey Herrington
- Division of Emergency Medicine, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Roz King
- Division of Emergency Medicine, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Miles Lamberson
- Division of Emergency Medicine, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Scott Mackey
- Division of Psychiatry, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Sanchit Maruti
- Division of Psychiatry, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Richard Rawson
- Division of Psychiatry, University of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Daniel Wolfson
- Division of Emergency Medicine, University of Vermont Larner College of MedicineBurlingtonVermontUSA
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17
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Pettus-Davis C, Kennedy SC, Veeh CA. Incarcerated individuals' experiences of COVID-19 in the United States. Int J Prison Health 2021; 17:335-350. [PMID: 33760428 DOI: 10.1108/ijph-11-2020-0094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aims to examine steps taken by correctional staff to prevent COVID-19 from spreading through correctional facilities and explores strategies used by incarcerated individuals to reduce their own risk of contracting COVID-19 during confinement. DESIGN/METHODOLOGY/APPROACH Data were drawn from interviews with 327 individuals incarcerated after March 16, 2020, in Midwest1, Midwest2 and Southeast state using a questionnaire developed for this purpose. All study participants were actively involved in a randomized controlled trial of a behavioral health reentry intervention and the human subjects board approved the supplement of this study on COVID-19; interviews were conducted from April 15 to November 19, 2020. FINDINGS Overall, 9.89% of participants contracted COVID-19. Most (68.50%) individuals learned about COVID-19 from television compared to official correctional facility announcements (32.42%). Participants wore face masks (85.02%), washed hands (84.40%) and practiced physical distancing when possible (66.36%). Participants reported that facilities suspended visitation (89.60%) and volunteers (82.57%), provided face masks (83.18%), sanitized (68.20%), conducted temperature checks (55.35%) and released individuals early (7.34%). SOCIAL IMPLICATIONS Longitudinal observational study on the implementation and effectiveness of public health guidelines in prisons and jails may identify best practices for containing the infectious disease. Maximizing transparent communications, as well as COVID-19 prevention and mitigation efforts, are critical to achieving universal best practices for virus containment and amplifying public health. ORIGINALITY/VALUE Data presented indicate the early adoption of many Centers for Disease Control guidelines by individuals and correctional facilities, although broad variation existed. Data support the identification of containment strategies for feasible implementation in a range of correctional spaces.
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Affiliation(s)
| | - Stephanie C Kennedy
- Institute for Justice Research and Development, Florida State University, Tallahassee, Florida, USA
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18
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Olding M, Barker A, McNeil R, Boyd J. Essential work, precarious labour: The need for safer and equitable harm reduction work in the era of COVID-19. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 90:103076. [PMID: 33321286 DOI: 10.1016/j.drugpo.2020.103076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/23/2023]
Abstract
This commentary highlights labour concerns and inequities within the harm reduction sector that hinder programs' ability to respond to converging public health emergencies (the overdose crisis and COVID-19), and potentially contribute to spread of the novel coronavirus. Many harm reduction programs continue to support people who use illicit drugs (PWUD) during the pandemic, yet PWUD working in harm reduction programs (sometimes termed 'peers') experience precarious labour conditions characterized by low wages, minimal employee benefits (such as paid sick leave) and high employment insecurity. Along with precarious labour conditions, PWUD face heightened vulnerabilities to COVID-19 and yet have been largely overlooked in global response to the pandemic. Operating under conditions of economic and legal precarity, harm reduction programs' reliance on precarious labour (e.g. on-call, temporary and unpaid work) renders some services vulnerable to staffing shortages and service disruptions during the pandemic, while also heightening the risk of virus transmission among workers, service users and their communities. We call for immediate policy and programmatic actions to strengthen working conditions within these settings with a priority on enhancing protections and supports for workers in peer roles.
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Affiliation(s)
- Michelle Olding
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, V6Z 1Y6; Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Allison Barker
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, V6Z 1Y6
| | - Ryan McNeil
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, V6Z 1Y6; Yale School of Medicine, New Haven, CT, United States; Yale School of Public Health, New Haven, CT, United States; Department of Anthropology, Yale University, New Haven, CT, United States
| | - Jade Boyd
- British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, V6Z 1Y6; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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19
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Improving retention across the OUD service cascade upon reentry from jail using Recovery Management Checkups-Adaptive (RMC-A) experiment. J Subst Abuse Treat 2020; 128:108245. [PMID: 33461829 DOI: 10.1016/j.jsat.2020.108245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
Incarcerated individuals with opioid use disorders (OUD) should be linked to community-based treatment with medications for opioid use disorder (MOUD) upon their release, as well as to services that provide support for their ongoing recovery. The RMC-A experiment will test an adapted version of the evidence-based Recovery Management Checkups (RMC), which provides treatment linkage, support for retention, and re-linkage as indicated at quarterly checkups. A total of 750 male and female individuals will be recruited from 5 county jails in Illinois and randomly assigned to 1 of 3 groups at release from jail: a) Monitoring and Treatment Referral (MTR); b) quarterly RMC (RMC-Q); or c) RMC-A, which adjusts the frequency and intensity of checkups based on the individual's assessed need for treatment at each checkup. Measurement includes quarterly research follow-up assessments for 2 years, urine tests, and records checks (treatment, mortality, recidivism). The study aims to evaluate: (1) the direct effects of RMC-Q/RMC-A on MOUD treatment initiation, engagement, retention, and re-linkage; (2) the indirect effects of RMC-Q/RMC-A (via months of MOUD) on public health outcomes (days of opioid use, OUD symptoms, quality of life, cost of health care utilization); (3) the indirect effects of RMC-Q/RMC-A (via months of MOUD and public health outcomes) on public safety outcomes (illegal activity, re-arrest, re-incarceration, cost of crime); and (4) the incremental costs and cost-effectiveness of MTR vs. RMC-Q vs. RMC-A on public health and public safety outcomes. This experiment will determine whether the adapted RMC model improves the overall effectiveness and cost-effectiveness of the fixed quarterly RMC.
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20
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Donelan CJ, Hayes E, Potee RA, Schwartz L, Evans EA. COVID-19 and treating incarcerated populations for opioid use disorder. J Subst Abuse Treat 2020; 124:108216. [PMID: 33288348 PMCID: PMC7708799 DOI: 10.1016/j.jsat.2020.108216] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/02/2020] [Accepted: 11/16/2020] [Indexed: 12/22/2022]
Abstract
The Franklin County Sheriff's Office (FCSO), in Greenfield, Massachusetts, is among the first jails nationwide to provide correctional populations with access to all three medications to treat opioid use disorder (MOUD, i.e., buprenorphine, methadone, naltrexone). In response to the COVID-19 pandemic, FCSO quickly implemented comprehensive mitigation policies and adapted MOUD programming. Two major challenges for implementation of the MOUD program were the mandated rapid release of nonviolent pretrial individuals, many of whom were being treated with MOUD and released too quickly to conduct continuity of care planning; and establishing how to deliver physically distanced MOUD services in jail. FCSO implemented and adapted a hub-and-spoke MOUD model, developed telehealth capacity, and experimented with take-home MOUD at release to facilitate continuity-of-care as individuals re-entered the community. Experiences underscore how COVID-19 accelerated the uptake and diffusion of technology-infused OUD treatment and other innovations in criminal justice settings. Looking forward, to address both opioid use disorder and COVID-19, jails and prisons need to develop capacity to implement mitigation strategies, including universal and rapid COVID-19 testing of staff and incarcerated individuals, and be resourced to provide evidence-based addiction treatment. FCSO quickly pivoted and adapted MOUD programming because of its history of applying public health approaches to address the opioid epidemic. Utilizing public health strategies can enable prisons and jails to mitigate the harms of the co-occurring epidemics of OUD and COVID-19, both of which disproportionately affect criminal justice populations, for persons who are incarcerated and the communities to which they return.
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Affiliation(s)
- Christopher J Donelan
- Franklin County Sheriff's Office, 160 Elm Street, Greenfield, MA 01301, United States of America
| | - Edmond Hayes
- Franklin County Sheriff's Office, 160 Elm Street, Greenfield, MA 01301, United States of America
| | - Ruth A Potee
- Franklin County Sheriff's Office, 160 Elm Street, Greenfield, MA 01301, United States of America
| | - Levin Schwartz
- Franklin County Sheriff's Office, 160 Elm Street, Greenfield, MA 01301, United States of America
| | - Elizabeth A Evans
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, 312 Arnold House, 715 North Pleasant Street, Amherst, MA 01003, United States of America.
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21
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Grebely J, Cerdá M, Rhodes T. COVID-19 and the health of people who use drugs: What is and what could be? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 83:102958. [PMID: 33183679 PMCID: PMC7837052 DOI: 10.1016/j.drugpo.2020.102958] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
SARS-CoV-2, the virus that causes COVID-19, has changed the world as we know it, and continues to do so. How COVID-19 affects people who use drugs, the environments in which they live, and capacities of response, warrants immediate attention. This special issue begins to map how COVID-19 is altering the health of people who use drugs, including in relation to patterns of drug use, service responses, harms that may relate to drug use, interventions to reduce risk of harms, COVID-19 health, and drug policies. We emphasise the need to envisage COVID-19 and its effects as a matter of intersecting ‘complex adaptive systems’: that is, the impacts of COVID-19 extend beyond the virus and related illness conditions to encompass multiple social, cultural, economic, policy and political effects; and these affect the health of people who use drugs directly as well as indirectly by altering the risk and enabling environments in which they live. We synthesize emergent evidence on the impact of COVID-19 on the health of people who use drugs. A key concern we identify is how to sustain policy and service delivery improvements prompted by COVID-19. We need to maintain an ethos of emergent adaptation and experimentation towards the creation of safer environments in relation to the health of people who use drugs.
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Affiliation(s)
- Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, Australia.
| | - Magdalena Cerdá
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, United States
| | - Tim Rhodes
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia; London School of Hygiene and Tropical Medicine, London, UK
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22
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Zielinski MJ, Hinton KE, Bull CE. COVID-19 highlights the pitfalls of reliance on the carceral system as a response to addiction. J Subst Abuse Treat 2020; 122:108190. [PMID: 33221126 PMCID: PMC7855050 DOI: 10.1016/j.jsat.2020.108190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/11/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
People who are incarcerated are likely to meet criteria for at least one substance use disorder and need access to treatment. Access to such interventions was limited prior to the COVID-19 pandemic and has almost certainly been restricted further due to implementation of procedures intended to stop the spread of the virus. In this brief commentary, we discuss how COVID-19 has revealed the already tenuous access that people who are incarcerated have to behavioral health services, and the pitfalls of reliance on the U.S. carceral system as a response to addiction.
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Affiliation(s)
- Melissa J Zielinski
- University of Arkansas for Medical Sciences, United States of America; University of Arkansas, Fayetteville, United States of America.
| | - Kendra E Hinton
- University of Arkansas for Medical Sciences, United States of America; Indiana University School of Medicine, United States of America
| | - Chelsey E Bull
- University of Central Arkansas, United States of America
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