Harm Reduction

Harm Reduction: A Public Health Approach to Prison Drug Use

Belisle, L. & Solano-Patricio, Elia D. (2021). Harm Reduction: A Public Health Approach to Prison Drug Use. International Journal of Prisoner Health. 18(4), 458-472. https://doi.org/10.1108/IJPH-06-2021-0053

This study explores harm reduction as an alternative to traditional methods for addressing prison drug use. It reviews existing research on three specific harm reduction programs: opioid agonist therapy, syringe exchange, and naloxone distribution. The findings suggest these programs are safe, effective in reducing harms, and underutilized compared to their use in society. Finally, the study proposes policy recommendations based on ethical considerations and the merits of a public health approach to prison drug use.

Opioid Use Disorder and Criminal Justice: Predicting the Use of OAT Within a Justice Involved Population

Guastaferro, W.P., Koetzle, D., Lutgen, L., & Teasdale, B. (2022). Opioid use disorder and criminal justice: Predicting the use of OAT within a justice involved population. Substance Use and Misuse, 57(5), 698-707. DOI: 10.1080/10826084.2022.2034869

Background: In 2014, nearly 2.5 million Americans had a substance use disorder for opioids (e.g., prescription pain medication or heroin) with over half estimated to have had prior contact with the criminal justice system. Despite strong evidence that opioid agonist treatment (OAT) is effective in reducing overdose, increasing treatment retention, and improving physical health and well-being outcomes, the use of OAT among justice-involved individuals is relatively rare. Methods: The current study uses national data of publicly funded admissions to substance abuse treatment to assess the extent to which OAT is used for cases referred to treatment by the criminal justice system. We explore the relationship between demographics, substance use severity, and access to treatment and OAT receipt. Results: Findings indicate that fewer than 6% of criminal justice cases received OAT as part of the treatment plan. Those with daily substance use, comorbid psychiatric problems, prior treatment, females, Latinos, and those who were older and those who were living independently were more likely to receive OAT, as were those living in the Northeast and with government health insurance. Conclusions: Improving the integration of the criminal justice system with substance use treatment programs would improve access to care and potentially reduce multiple health disparities faced by those in the justice system. As criminal justice responses to substance use disorder move toward a public health approach, it is imperative that the criminal justice system consider mechanisms for improving access and referrals to OAT.

The Realities and Myths of Drug Offender Treatment

Koetzle, D. (2019). The Realities and Myths of Drug Offender Treatment. Presented at TEDx Oneonta, New York. Available at: https://www.ted.com/talks/deborah_koetzle_koetzle_addressing_crime_and_drug_use_through_community_based_interventions

In this TEDx talk, Debi Koetzle shares the importance of having effective community based interventions for justice-involved people struggling with drug or alcohol use. Drawing on her family’s experience, she reviews the risk-need-responsivity framework and its implications for reducing recidivism and facilitating desistance.