Work expands to prevent opioid overdoses for people leaving prison

Chesterfield County, Virginia implemented a multi-faceted response to the opioid crisis, including a jail-based recovery program, Helping Addicts Recover Progressively (HARP), that brings people in recovery to the local jail to talk about addiction and treatment resources. Combined with other efforts, overdose deaths have dropped by half in a single year, and around 4,000 people have participated in HARP.

In response to the dangerous gap in health services that incarcerated people face upon release, California and 26 other states have implemented Medicaid waivers allowing coverage to begin up to 90 days before release and continue for up to a year afterward. The program connects inmates with case managers, medications, housing assistance, and mental health care before they walk out the door. California's program has already enrolled more than 50,000 incarcerated people in prerelease services since January 2023.

Intervention Court provides programming and support to those struggling with addiction, connecting them to jobs, schooling and skills training to help them stay sober, re-enter society and stay out of jail. Nearly 11,000 people have graduated from one of the 42 drug courts throughout the state, and the courts average a recidivism rate of just 2.9% compared to the Mississippi Department of Corrections’ 35.4%.

First Day Forward provides support and assistance to people with substance use disorders who are reentering the community after incarceration in seven rural counties. The program is driven by peer-support specialists who have lived experience to provide trusting support to those seeking assistance. The program has been shown to work as the recidivism rate for those who’ve successfully completed it has dropped to 23.5%, compared to 53.2% in a nearby county.

Women in Recovery is a diversion program for women who would otherwise face prison time for drug-related offenses. The comprehensive program lasts 18 months and helps participants restore their mental health, reunite with their children, develop skills that help them get jobs, secure housing and reenter the community. Women in Recovery helps reduce recidivism rates and 70% of women who start the program complete it and graduate.

With the new statewide Medicaid expansion, the Department of Adult Correction is working to ensure fewer people reenter society after incarceration and enter a healthcare coverage gap by helping people apply for Medicaid before release. With the Medicaid expansion, 80% of the 15,000 people released from prison each year are now eligible for coverage, and prison staff submit about 100 Medicaid applications each week.

Medically assisted treatment is proven to reduce fatal opioid overdoses, particularly among formerly incarcerated people. When people are denied treatment in jail or prison and then resume their previous doses once they're released, they are up to 40 times more likely to die of an overdose. Only 18 of New York's county jails and fewer than one in five of its prisons provide access to such treatment drugs as Suboxone and methadone. When Rhode Island became the first state to make MAT available throughout its prisons, its overdose deaths among people recently released from incarceration dropped 60%.

In order to reduce opioid related deaths, Rhode Island has taken a rare step among state prisons: offer medication and drug counseling to opioid addicts. The Rhode Island Department of Corrections gives small doses of either methadone, buprenorphine or naltrexone to inmates, as well as drug counseling. "I still have to fight the other drugs… But at least I have something to help with one of the ones that's brought me closer to death than anything else." Evidence show the program is working. There was "a significant drop in overdose deaths among people recently released from prison."

Newly passed legislation in Massachusetts is allowing prisons to take a step towards managing inmates health care by letting a third party company administer medication that helps treat opioid addiction. This step towards bridging the gap between punishment and help, also focuses on reducing racial inequalities and rates of addiction-caused deaths.

The Ohio Reformatory for Women is a prison that offers inmates a chance to enroll in Tapestry, an inpatient drug treatment program that tries to delve into the deeper causes women turn to drugs. It also believes in connecting women who are addicts with one another because “on the outside there’s not enough support.” The 18 month program is “about healing mind, body and spirit.”