Identifying structural risk factors for overdose following incarceration: a concept mapping study

• Main Authors: Samantha K. Nall (Author), Cole Jurecka (Author), Anthony Ammons (Author), Avel Rodriguez (Author), Betsy Craft (Author), Craig Waleed (Author), Daniel Dias (Author), Jessie Henderson (Author), Joshua Boyer (Author), Kristina Yamkovoy (Author), Pallavi Aytha Swathi (Author), Prasad Patil (Author), Forrest Behne (Author), Katherine LeMasters (Author), Lauren Brinkley-Rubinstein (Author), Joshua A. Barocas (Author)
• Format: Book
• Published: BMC, 2024-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s40352-024-00265-w; 2194-7899
• Keywords: Concept mapping; Community-engaged research; Overdose; Substance use disorder; Incarceration; Qualitative; Public aspects of medicine; RA1-1270; Social pathology. Social and public welfare. Criminology; HV1-9960
• Source: Health & Justice, Vol 12, Iss 1, Pp 1-14 (2024)

Abstract Background Currently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities. People with lived experiences in the criminal legal system and with substance use disorder hold unique perspectives and must be involved in the research process. Objective To identify perceived factors that impact overdose following release from incarceration among people with direct criminal legal involvement and experience with substance use. Methods Within a community-engaged approach to research, we used concept mapping to center the perspectives of people with personal experience with the carceral system. The following prompt guided our study: "What do you think are some of the main things that make people who have been in jail or prison more and less likely to overdose?" Individuals participated in three rounds of focus groups, which included brainstorming, sorting and rating, and community interpretation. We used the Concept Systems Inc. platform groupwisdom for our analyses and constructed cluster maps. Results Eight individuals (ages 33 to 53) from four states participated. The brainstorming process resulted in 83 unique factors that impact overdose. The concept mapping process resulted in five clusters: (1) Community-Based Prevention, (2) Drug Use and Incarceration, (3) Resources for Treatment for Substance Use, (4) Carceral Factors, and (5) Stigma and Structural Barriers. Conclusions Our study provides critical insight into community-identified factors associated with overdose following incarceration. These factors should be accounted for during resource planning and decision-making.