Overdose education and naloxone distribution among women with a history of OUD transitioning to the community following jail release

BACKGROUND: The criminal legal system (CLS) provides a critical intervention point for women at high risk for overdose, and the need continues to rise as the number of incarcerated women increases. Effective, targeted prevention interventions to reduce overdose risk for CLS-involved women are needed, such as naloxone distribution. This study describes the overdose education and naloxone distribution (OEND) procedures used in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN).

METHOD: Participants included women incarcerated in nine Kentucky jails (N = 900) who were randomly selected, screened for opioid use disorder, and consented for the study. They were followed three-months following jail release to examine naloxone utilization and overdose experiences.

RESULTS: Study findings indicate that about three-quarters (74.4%) of women in this study reported lifetime injection and more than half (54.9%) had a lifetime history of a non-fatal overdose prior to entering jail. About 70% of women reported receiving a study naloxone unit upon jail release, and of those, 30 women reported using the unit during the three-month post-release window. About 4% of the sample reported a non-fatal overdose during this same time period.

CONCLUSIONS: Incarcerated women in this sample reported a history of behaviors that may signal overdose risk upon release to the community such as injection drug use and non-fatal overdose. Study findings suggest targeted OEND efforts for women in general are desperately needed, and particularly among women at highest risk during community re-entry.