Preventing Death Among the Recently Incarcerated: An Argument for Naloxone Prescription Before Release

ABSTRACT

Death from opiate overdose is a tremendous source of mortality, with a heightened risk in the weeks following incarceration. The goal of this study is to assess overdose experience and response among long-term opiate users involved in the criminal justice system. One hundred thirty-seven subjects from a project linking opiate-dependent individuals being released from prison with methadone maintenance programs were asked 73 questions regarding overdose. Most had experienced and witnessed multiple overdoses; 911 was often not called. The majority of personal overdoses occurred within 1 month of having been institutionalized. Nearly all participants expressed an interest in being trained in overdose prevention with Naloxone. The risk of death from overdose is greatly increased in the weeks following release from prison. A pre-release program of overdose prevention education, including Naloxone prescription, for inmates with a history of opiate addiction would likely prevent many overdose deaths.

KEYWORDS:

• Naloxone
• opiate
• overdose
• prison
• incarceration

Acknowledgments

The authors thank the staff of Projects MOD and ROMEO. MOD was supported by grant number 6H79TI14562 from the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA/CSAT). ROMEO was supported by grant 1 RO1 DA 018641-01 from the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH). Partial support was provided by grant number P30-AI-42853 from the National Institutes of Health, Center for AIDS Research (NIH/CFAR).

Notes

^a Of those who witnessed an overdose.