People leaving incarceration are at high risk of opioid-related overdose. Overdose fatalities are preventable with administration of naloxone. In response to this risk, overdose education and naloxone distribution (OEND) programs have been implemented in a handful of jails and prisons in the United States. We document the history, structure, and data from the San Francisco County Jail OEND program. During 4 years of operation, 637 people participated; 67% received naloxone upon release, of whom only 3.5% had been previously trained in community-based OEND programs. Of those who received naloxone, 32% reported reversing an overdose and 44% received refills from community-based programs after reentry. This confirms that implementation of OEND in criminal justice settings is feasible and reaches people who have not previously been trained as well as those willing to act as overdose responders.
AlexB., WeissD. B., KabaF., RosnerZ., LeeD., LimS.…MacDonaldR. (2017). Death after jail release. Journal of Correctional Health Care, 23, 83–87. doi:10.1177/1078345816685311
2.
BagleyS. M., FormanL. S., RuizS., CranstonK., WalleyA. Y. (2017). Expanding access to naloxone for family members: The Massachusetts experience. Drug and Alcohol Review, 37, 480–486. doi:10.1111/dar.12551
3.
BathjeG., JungeE. (2016, November). Overdose prevention within law enforcement and incarceration systems. In McCordD. (Moderator), Overdose in the criminal justice system. Panel conducted at the 11th National Harm Reduction Conference, San Diego, CA.
4.
BennettT., HollowayK. (2012). The impact of take-home naloxone distribution and training on opiate overdose knowledge and response: An evaluation of the THN project in wales. Drugs: Education, Prevention and Policy, 19, 320–328.
5.
BinswangerI. A., BlatchfordP. J., MuellerS. R., SternM. F. (2013). Mortality after prison release: Opioid overdose and other causes of death, risk factors, and time trends from 1999 to 2009. Annals of Internal Medicine, 159, 592–600. doi:10.7326/0003-4819-159-9-201311050-00005
6.
BinswangerI. A., SternM. F., DeyoR. A., HeagertyP. J., CheadleA., ElmoreJ. G., KoepsellT. D. (2007). Release from prison—A high risk of death for former inmates. New England Journal of Medicine, 356, 157–165. doi:10.1056/NEJMsa064115
7.
BirdS. M., McAuleyA., PerryS., HunterC. (2016). Effectiveness of Scotland’s National Naloxone Programme for reducing opioid-related deaths: A before (2006-10) versus after (2011-13) comparison. Addiction, 111, 883–891. doi:10.1111/add.13265
8.
BoneC., EysenbachL., BellK., BarryD. T. (2018). Our ethical obligation to treat opioid use disorder in prisons: A patient and physician’s perspective. Journal of Law, Medicine & Ethics, 46, 268–271. doi:10.1177/1073110518782933
City and County of San Francisco Sheriff’s Department. (2017). San Francisco county jail system facility descriptions/ county jail #2. Retrieved from http://www.sfsheriff.com/jail_info.html
11.
CoffinP. O., SullivanS. D. (2013). Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal in Russian cities. Journal of Medical Economics, 16, 1051–1060. doi:10.3111/13696998.2013.811080
12.
DavisC. S., CarrD. (2017). State legal innovations to encourage naloxone dispensing. Journal of the American Pharmacists Association, 57, S180–S184.
13.
DavisC. S., SouthwellJ. K., NiehausV. R., WalleyA. Y., DaileyM. W. (2014). Emergency medical services naloxone access: A national systematic legal review. Academic Emergency Medicine, 21, 1173–1177. doi:10.1111/acem.12485
14.
Doe-SimkinsM., QuinnE., XuanZ., Sorensen-AlawadA., HackmanH., OzonoffA., WalleyA. Y. (2014). Overdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: A retrospective cohort study. BMC Public Health, 14, 297. doi:10.1186/1471-2458-14-297
15.
DowellD., AriasE., KochanekK., AndersonR., GuyG. P.Jr, LosbyJ. L., BaldwinG. (2017). Contribution of opioid-involved poisoning to the change in life expectancy in the United States, 2000-2015. Journal of the American Medical Association, 318, 1065–1067. doi:10.1001/jama.2017.9308
16.
DoyonS., AksS. E., SchaefferS. (2014). Expanding access to naloxone in the United States. Journal of Medical Toxicology, 10, 431–434. doi:10.1007/s13181-014-0432-1
17.
EnteenL., BauerJ., McLeanR., WheelerE., HuriauxE., KralA. H., BambergerJ. D. (2010). Overdose prevention and naloxone prescription for opioid users in San Francisco. Journal of Urban Health, 87, 931–941. doi:10.1007/s11524-010-9495-8
18.
GreenT. C., BowmanS. E., RayM., McKenzieM., LordS. E., RichJ. D. (2014). Development of an incarceration-specific overdose prevention video: “Staying Alive on the Outside”. Health Education Journal, 74, 627–637.
19.
GreenT. C., ClarkeJ., Brinkley-RubinsteinL., MarshallB. D. L., Alexander-ScottN., BossR., RichJ. D. (2018). Postincarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. Journal of the American Medical Association Psychiatry, 75, 405–407. doi:10.1001/jamapsychiatry.2017.4614
20.
HaasE., ForsethK. (2016, November). Overdose education and naloxone delivery in local detention centers in Maryland. In McCordD. (Moderator), Overdose in the criminal justice system. Panel conducted at the 11th National Harm Reduction Conference, San Diego, CA.
21.
HedegaardH., WarnerM., MiniñoA. M. (2017). Drug overdose deaths in the United States, 1999-2016 (NCHS Data Brief no. 294). Hyattsville, MD: National Center for Health Statistics.
22.
HorsburghK., McAuleyA. (2018). Scotland’s National Naloxone Program: The prison experience. Drug and Alcohol Review, 37, 454–456. doi:10.1111/dar.12542
23.
HortonM., McDonaldR., GreenT. C., NielsenS., StrangJ., DegenhardtL., LarneyS. (2017). A mapping review of take-home naloxone for people released from correctional settings. International Journal on Drug Policy, 46, 7–16. doi:10.1016/j.drugpo.2017.05.015
24.
Huxley-ReicherZ., MaldjianL., WinkelsteinE., SieglerA., PaoneD., TuazonE.…KuninsH. V. (2018). Witnessed overdoses and naloxone use among visitors to Rikers Island jails trained in overdose rescue. Addictive Behaviors, 86, 72–78. doi:10.1016/j.addbeh.2017.11.029
25.
KleinS., TolbertM., BugarinR., CataldiE. F., TauschekG. (2004). Correctional education: Assessing the status of prison programs and information needs. Washington, DC: Office of Safe and Drug-Free Schools, U.S. Department of Education. Retrieved from https://files.eric.ed.gov/fulltext/ED543577.pdf
26.
LimS., SeligsonA. L., ParvezF. M., LutherC. W., MavinkurveM. P., BinswangerI. A., KerkerB. D. (2012). Risks of drug-related death, suicide, and homicide during the immediate post-release period among people released from New York City jails, 2001-2005. American Journal of Epidemiology, 175, 519–526. doi:10.1093/aje/kwr327
27.
LimeSurvey GmbH. (2018). Professional online surveys with LimeSurvey. Retrieved from https://www.limesurvey.org/
28.
MarunaS. (2001). Making good: How ex-convicts reform and rebuild their lives. Washington, DC: American Psychological Association.
29.
MerrallE. L., KariminiaA., BinswangerI. A., HobbsM. S., FarrellM., MarsdenJ.…BirdS. M. (2010). Meta-analysis of drug-related deaths soon after release from prison. Addiction, 105, 1545–1554. doi:10.1111/j.1360-0443.2010.02990.x
National Research Council. (2008). Parole, desistance from crime, and community integration. Washington, DC: National Academies Press.
32.
RuddR. A., SethP., DavidF., SchollL. (2016). Increases in drug and opioid-involved overdose deaths—United States, 2010-2015. Morbidity and Mortality Weekly Report, 65, 1445–1452. doi:10.15585/mmwr.mm655051e1
33.
SampsonR. J., LaubJ. H. (1993). Crime in the making: Pathways and turning points through life. Cambridge, MA: Harvard University Press.
34.
SealK. H., ThawleyR., GeeL., BambergerJ., KralA. H., CiccaroneD.…EdlinB. R. (2005). Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: A pilot intervention study. Journal of Urban Health, 82, 303–311. doi:10.1093/jurban/jti053
35.
ShermanS. G., GannD. S., ScottG., CarlbergS., BiggD., HeimerR. (2008). A qualitative study of overdose responses among Chicago IDUs. Harm Reduction Journal, 5, 2. doi:10.1186/1477-7517-5-2
36.
ShermanS. G., GannD. S., TobinK. E., LatkinC. A., WelshC., BielensonP. (2009). “The life they save may be mine”: Diffusion of overdose prevention information from a city sponsored programme. International Journal on Drug Policy, 20, 137–142. doi:10.1016/j.drugpo.2008.02.004
37.
SieglerA., Huxley-ReicherZ., MaldjianL., JordanR., OliverC., JakubowskiA., KuninsH. V. (2017). Naloxone use among overdose prevention trainees in New York City: A longitudinal cohort study. Drug and Alcohol Dependence, 179, 124–130. doi:10.1016/j.drugalcdep.2017.06.029
38.
SporerK. A., KralA. H. (2007). Prescription naloxone: A novel approach to heroin overdose prevention. Annals of Emergency Medicine, 49, 172–177. doi:10.1016/j.annemergmed.2006.05.025
39.
TobinK. E., ShermanS. G., BeilensonP., WelshC., LatkinC. A. (2009). Evaluation of the staying alive programme: Training injection drug users to properly administer naloxone and save lives. International Journal on Drug Policy, 20, 131–136. doi:10.1016/j.drugpo.2008.03.002
WagnerK. D., DavidsonP. J., IversonE., WashburnR., BurkeE., KralA. H.…LankenauS. E. (2014). “I felt like a superhero”: The experience of responding to drug overdose among individuals trained in overdose prevention. International Journal on Drug Policy, 25, 157–165. doi:10.1016/j.drugpo.2013.07.003
42.
WagnerK. D., ValenteT. W., CasanovaM., PartoviS. M., MendenhallB. M., HundleyJ. H.…UngerJ. B. (2010). Evaluation of an overdose prevention and response training programme for injection drug users in the Skid Row area of Los Angeles. CA. International Journal on Drug Policy, 21, 186–193. doi:10.1016/j.drugpo.2009.01.003
43.
WheelerE., JonesT. S., GilbertM. K., DavidsonP. J. (2015). Opioid overdose prevention programs providing naloxone to laypersons—United States, 2014. Morbidity and Mortality Weekly Report, 64, 631–635.
44.
WhiteV., StancliffS., BreslinD. (2016, November). Training incarcerated individuals prior to release and equipping them with naloxone upon release. In McCordD. (Moderator), Overdose in the criminal justice system. Panel conducted at the 11th National Harm Reduction Conference, San Diego, CA.
45.
ZuckerH., AnnucciA. J., StancliffS., CataniaH. (2015). Overdose prevention for prisoners in New York: A novel program and collaboration. Harm Reduction Journal, 12, 51. doi:10.1186/s12954-015-0084-8
