MedicalResearch.com Interview with:
Tyler Winkelman MD, MSc
Division of General Internal Medicine, Hennepin Healthcare
Center for Patient and Provider Experience, Hennepin Healthcare Research Institute
Departments of Medicine & Pediatrics
University of Minnesota
MedicalResearch.com: What is the background for this study?
Response: Opioid overdose deaths continue to escalate, and there have been reports that jails and prisons are bearing the brunt of the opioid epidemic. However, it wasn’t known, nationally, how many people who use opioids were involved in the criminal justice system. We also didn’t have recent estimates of common physical and mental health conditions among people with different levels of opioid use.
We used two years of national survey data to understand these associations, which are critical in developing a public health response to the opioid epidemic.
MedicalResearch.com: What are the main findings?
Response: People who use opioids, either heroin or prescription opioids, were up to 13 times more likely to be involved in the criminal justice system in the past year and had significantly more physical and mental health problems compared to the general population. Criminal justice involvement increased as opioid use increased. 3% of the general population reported criminal justice involvement in the past year compared to 20% of people with an opioid use disorder and 40% of people who use heroin. Health status also generally worsened as opioid use increased.
MedicalResearch.com: What should readers take away from your report?
Response: Criminal justice involvement among people who use opioids was more common than we anticipated. Frequent involvement with the criminal justice system is problematic because it can disrupt or delay substance use treatment.
We need to ensure jails and prisons have the resources needed to address the opioid epidemic. For example, policy makers could provide funding that bolsters the capacity of jails and prison to provide medication for opioid use disorders, as well as counseling for both their mental health and substance use.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Research out of Rhode Island suggests that treating opioid use disorders during incarceration can reduce overdose deaths at the population level. We need more research to understand how best to implement opioid treatment programs within correctional settings, how to link treatment between criminal justice and health care systems, and, ultimately, divert people with opioid use disorders from the criminal justice system.
Winkelman TN, Chang VW, Binswanger IA. Health, Polysubstance Use, and Criminal Justice Involvement Among Adults With Varying Levels of Opioid Use. JAMA Network Open. 2018;1(3):e180558. doi:10.1001/jamanetworkopen.2018.0558
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