COVID-19, Corrections, and Early-Release: Implications and Solutions for Populations with Opioid and Substance Use Disorders

Abstract

As the United States continues to feel the weight of the delta variant, it is a time of reflection. This global pandemic serves as a reminder that infectious diseases pose an existential threat to our way of life and the way we operate institutions. Correctional facilities are one of many institutions that are high-risk environments and require a nuanced approach to policies and practices. Epidemic planning, as part of a robust disaster/crisis response, may include correctional early releases in order to reduce census and subsequent risk associated with congregate living. However, early release planning must equitably balance inherent risks that marginalized people face, including those with opioid and other substance use disorders (OUD/SUDs). The majority (80-85%) of individuals incarcerated have reported illicit substance use in their lifetime, but only 20% receive treatment while incarcerated. Releasing individuals with OUD/SUDs early due to COVID-19 or another epidemic or pandemic, without a robust reentry plan may result in a return to substance use, fatal and nonfatal drug overdose, and recidivism. This report describes the risks associated with this practice and provides comprehensive policy recommendations incorporating a COVID-19 risk assessment, considerations for OUD/SUD, mental health (MH), healthcare access and resources, recovery housing, and employment. COVID-19 variants and emerging infectious diseases pose an ongoing threat; therefore prevention/planning and response efforts should take place in all sectors. This policy may be adapted to future early release planning scenarios to adequately balance risk and support successful transitions.

Note:
Funding: This manuscript is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $10.4 million.

Declaration of Interests: None to declare.