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Half of all drug users in rural areas were recently jailed

A new study led by Oregon Health & Science University (OHSU) has uncovered startling statistics about the intersection of drug use and incarceration in rural America. The research reveals that nearly half of rural illicit drug users have been incarcerated within the past six months, emphasizing a critical juncture for addiction treatment intervention.

Survey results

The study, which spanned across eight rural areas in 10 states, involved a survey of almost 3,000 people. This extensive research has shed light on the pervasive issue of drug use in these communities. 

A staggering 42% of respondents, who admitted to using illicit drugs, reported having been imprisoned either in local jails or prisons in the six months leading up to the survey.

Studying drug use in rural areas 

The research was conducted by experts from OHSU and various institutions across the United States. The team investigated the complex relationship between drug use and the criminal justice system in rural areas. 

The findings underscore the pressing need to address the nation’s opioid crisis through expanded addiction treatment, specifically targeting those currently in custody.

“You have a reachable time in jails, and most jails are not providing this kind of addiction care,” said study lead author Dr. Dan Hoover. “In a broader sense, our correctional institutions have a mandate to rehabilitate people who have entered the system – and treating addiction is a huge part of that.”

Broader implications

Dr. Hoover pointed to a Rhode Island study that showed a 12% decrease in statewide overdoses following the implementation of medication-assisted therapy in its prison system in 2016. 

The common practice of leaving incarcerated individuals to endure withdrawal without treatment increases their vulnerability to resuming drug use, engaging in criminal activities, and facing a heightened risk of overdose upon release.

“Many of these individuals are released back to the community within days,” said Dr. Hoover. “Their health is community health. That time in jail is the reachable moment to begin their path to treatment and recovery.”

Rural Opioid Initiative

The study is part of the Rural Opioid Initiative and covers a wide geographic span, including 65 counties in Oregon, Illinois, Wisconsin, North Carolina, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire, and Vermont.

Highlighting recent efforts in New Jersey and Seattle, the study points to developing pathways for treatment and recovery for inmates during and after incarceration.

Treatment for drug users

The experts noted the challenges posed by the lack of funding for substance use disorder (SUD) treatment within the criminal legal system and the absence of health insurance coverage during incarceration, which contribute to poor SUD treatment access for this population.

Despite the availability of FDA-approved medications like methadone, buprenorphine, and naltrexone for opioid use disorder, their provision remains rare in American prison systems. 

In Oregon, access to buprenorphine is available in the state prison system, but is inconsistent in local jails.

“Lack of criminal legal system funding apportioned for (substance use disorder, or SUD) treatment and lack of health insurance coverage during incarceration further contribute to poor SUD treatment access for this population,” wrote the researchers.

The study is published in the journal JAMA Network Open.

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