Interventions for incarcerated adults with opioid use disorder in the United States: A systematic review with a focus on social determinants of health

Autoři: Olivia K. Sugarman aff001;  Marcus A. Bachhuber aff001;  Ashley Wennerstrom aff001;  Todd Bruno aff004;  Benjamin F. Springgate aff001
Působiště autorů: Center for Healthcare Value and Equity, Louisiana State University Health Sciences Center–New Orleans, New Orleans, Louisiana, United States of America aff001;  Section of Community and Population Medicine, Department of Medicine, School of Medicine, Louisiana State University Health Sciences Center–New Orleans, New Orleans, Louisiana, United States of America aff002;  Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center–New Orleans, New Orleans, Louisiana, United States of America aff003;  Schwartz Law Firm, LLC, Mount Pleasant, South Carolina, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227968


Incarceration poses significant health risks for people involved in the criminal justice system. As the world’s leader in incarceration, the United States incarcerated population is at higher risk for infectious diseases, mental illness, and substance use disorder. Previous studies indicate that the mortality rate for people coming out of prison is almost 13 times higher than that of the general population; opioids contribute to nearly 1 in 8 post-release fatalities overall, and almost half of all overdose deaths. Given the hazardous intersection of incarceration, opioid use disorder, and social determinants of health, we systematically reviewed recent evidence on interventions for opioid use disorder (OUD) implemented as part of United States criminal justice system involvement, with an emphasis on social determinants of health (SDOH). We searched academic literature to identify eligible studies of an intervention for OUD that was implemented in the context of criminal justice system involvement (e.g., incarceration or parole/probation) for adults ages 19 and older. From 6,604 citations, 13 publications were included in final synthesis. Most interventions were implemented in prisons (n = 6 interventions), used medication interventions (n = 10), and did not include SDOH as part of the study design (n = 8). Interventions that initiated medication treatment early and throughout incarceration had significant, positive effects on opioid use outcomes. Evidence supports medication treatment administered throughout the period of criminal justice involvement as an effective method of improving post-release outcomes in individuals with criminal justice involvement. While few studies included SDOH components, many investigators recognized SDOH needs as competing priorities among justice-involved individuals. This review suggests an evidence gap; evidence-based interventions that address OUD and SDOH in the context of criminal justice involvement are urgently needed.

Klíčová slova:

Behavioral and social aspects of health – Criminal justice system – Drug therapy – Employment – Health education and awareness – Opioids – Prisons – Systematic reviews


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