The Deadly Link Between Incarceration and Opioids

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Illustration by Natasha Mayers via Flickr

Mass incarceration is driving high numbers of drug-related deaths, according to a study published in The Lancet Public Health journal.

The formerly incarcerated often return to their home communities to face the bleak economic or social environments they left before going to prison—but with even greater risk of falling into circumstances that lead to addiction and the risk of fatal overdose, said the study.

With lower household income and high incarceration rates already associated with poor health, the study argued, “the rapid expansion of the prison and jail population in the USA over the past four decades might have contributed to the increasing number of deaths from drug use disorders.”

Research has established that the widespread prescription of pain medications along with economic misfortunes have been key factors in the opioid epidemic that has plagued the nation over the past several decades.

But, the study added, “We argue that these two explanations, although valid, are incomplete, and that incarceration represents another major driver of the epidemic in drug-related deaths.”

The study, conducted by Elias Nosrati of the University of Oxford and four colleagues, examined mortality data, household income data, and prison and jail data for 2,640 U.S. counties between 1983 and 2014.

Each standard deviation increase in jail incarceration rates was associated with a 1.5 percent increase in drug-related mortality. Each standard deviation increase in prison incarceration rates was associated with 2.6 percent increase in drug-related mortality, the study found.

Drug-related deaths are also linked to economic problems. According to the study, each standard deviation decrease in household income was associated with a 12.8 percent increase in drug-related deaths within counties.

The study emphasized the crises of mass incarceration and drug-related deaths to argue how they are related. Over 72,000 overdose deaths occurred in 2017. As of 2014, there were over 1.5 million people incarcerated in state and federal prisons and 744,600 were incarcerated in local jails, according to the study.

“Extensive evidence has linked incarceration to various factors that are associated with drug overdoses, including stigma, unemployment, family disruption, and neighborhood decline,” the authors said.

The other authors of the study were: Jacob Kang-Brown of the Vera Institute of Justice; Michael Ash and Lawrence P. King of the University of Massachusetts at Amherst; Martin McKee of the London School of Hygiene and Tropical Medicine; and Michael Marmot of University College, London.

You can read the full study here.

This summary was prepared by TCR intern Maria Trovato.

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