Overdoses and deaths related to substance use didn't increase after a large-scale prison release, shows study

Contrary to expectations, the risk for relapses, overdoses and deaths related to substance use disorder didn't increase after a large-scale prison release in New Jersey, according to a Rutgers study.

The study, published in JAMA Health Forum, examined whether post-release overdose deaths and drug-related hospital and emergency department visits increased after more than 2,000 individuals were released from prison in late 2020 as the result of a pandemic-era policy.

"Risk of relapse and adverse health events is high following prison release, with risk of fatal overdose as much as 129 times greater in the two weeks post-release than in the general population," said Peter Treitler, a research project manager at the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) and lead author of the study.

In November 2020, New Jersey enacted the Public Health Emergency Credit Act to reduce COVID-19 transmission among people in state prisons. The legislation resulted in the release of more than 2,000 individuals in one day. The large-scale release posed concerns regarding the capacity of reentry services and a potential increased risk for relapse or drug overdose for individuals with substance use disorders, according to researchers.

The researchers analyzed prison releases among incarcerated individuals with substance use disorders in New Jersey from 2019 to 2020 and examined hospital and death records within 45 days after their release from prison. They found the risk of overdose or death in individuals with substance use disorder after the mass prison release in 2020 didn't increase compared with earlier periods of time.

"New Jersey has robust reentry supports for incarcerated people with substance use disorder, which may have lowered post-release risks," said Treitler. "N.J."s decarceration experience may provide a model for future policy reform as correctional systems seek to reduce incarceration without increasing health risk."

Researchers said next steps for further study include assessing outcomes after longer periods of time and examining additional health-related outcomes, such as primary care utilization and adherence to medication treatment for those released on medications for opioid use disorder.

Co-authors of the study include Molly Nowels and Stephen Crystal of IFH; Rusty Reeves and Lisa DeBilio of Rutgers University Correctional Health Care; and Kenneth Feder and Brendan Saloner of the Johns Hopkins Bloomberg School of Public Health.