Jails and Corrections Individuals with a history of drug use who are leaving jail or prison have a great likelihood of overdosing in the first 2 weeks following discharge. Correctional settings are great places to provide overdose prevention information and ideally, naloxone prescription at the time of discharge. Overdose prevention groups can be provided to individuals in treatment programs in prison/jail, on open tiers where educational groups are offered or in classrooms. It is also beneficial to work with probation offices, drug courts and pre-trial diversion programs to provide overdose prevention education and when allowed, naloxone prescription. As a program or individual providing harm reduction services, it can be challenging to get access into the correctional system to provide overdose education, but several programs across the country (in San Francisco, Pittsburgh, New York City, Baltimore, Massachusetts, Rhode Island and several facilities in New Mexico) have made it happen. As of now, none of these programs distribute naloxone to inmates while they are incarcerated, or as they are leaving custody, but they do provide vital overdose education and referral to local naloxone programs on the outside.
To gain entrée to the correctional system, it is important to find an ally, someone who is on the inside who you can present the idea to, and who has the power to help move it through the proper channels to gain approval from the facility. Some jails and prisons have public health interventions in place already, like HIV testing or peer-led HIV prevention, or they have a jail health program that could be a good place to start. You can also check to see if the correctional system has an offender re-entry program, or case management program — these are also possible places to find an ally who understands the increased risk of overdose for people leaving prison and re-entering the community. If your local department of public health already works within the prisons, contact them to inquire about proposing an overdose prevention group. Many jails and prisons also have drug treatment components that may be interested in incorporating overdose prevention into their existing workshops and group activities.
Providing Overdose Prevention Training in a Corrections Setting Respect authority! This might be a tough one, but the correctional system is rigidly hierarchical and there are many rules and policies intended to keep inmates, correctional officers and visitors safe. Some of these policies might seem ridiculous, inappropriate or downright abusive to you, but remember that you are their guest; policies must be respected or you won’t be allowed in to do the important work that you want to do. So: Follow their rules. Vent later. Your goal is to get information to the individuals who are locked up, and dealing with correctional officers and prison administrators is the only way you’ll get to do that. Plus, sometimes they can be great allies, so don’t assume the worst from the start. Similar to the suggestion above, follow the proper channels to get approval to enter the corrections system and keep all relevant parties informed of your intentions, content and actions. Similar to providing overdose prevention in drug treatment settings, If participants (or correctional officers, wardens, etc.) express discomfort about discussing drug use or relapse, it’s important to try framing the training as “how to save a life” and to discuss the possibility of witnessing overdose among other people, like family or friends, who may continue to use and who may be at risk.
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