Prison Inmates 40 Times More Likely to Die From Opioid Overdose Two Weeks After Release

A man holds a heroin needle in June 2017 in New York City. Former prisoners are 40 times as likely as average citizens to die of an opioid overdose less than two weeks after their release, a study found, evidence that a lack on in-prison substance abuse treatment feeds the growing opioid crisis. (Photo by Spencer Platt/Getty Images)

For almost 80 percent of inmates, life after release often lands them back in prison. For others, that "revolving door" stops with a fatal drug overdose, usually days after their sentence ends, researchers said.

Within the first two weeks of their release, former inmates were 40 times more likely to die of an opioid overdose than an average citizen, a study published Thursday in the American Journal of Public Health found. Researchers argue the results show how the lack of resources in and out of prison to treat substance abuse is aggravating America's opioid crisis that claimed more than 42,000 lives in 2016.

Researchers surveyed nearly 230,000 former inmates released from North Carolina between 2000 and 2015 and compared their rates of fatal opioid overdoses with North Carolina residents. Even one year after release, the inmates were still 11 times more likely to overdose on heroin than any other citizen.

The risk of fatal opioid overdose was highest among male white prisoners ages 26 to 50, especially those who had served more than two previous sentences and received substance abuse and mental health treatment during past terms.

Almost 70 percent of individuals of former North Carolina prisoners have substance abuse disorder, researchers said. During their incarceration, former users are forced to withdraw from the drug, lowering their tolerance so that when they leave prison and use again, they experience a harsher high.

The support system for released prisoners, even those without substance abuse problems, is insufficient, lead author Shabbar Ranapurwala said. Of the 355,000-plus prisoners who are mentally ill, only one-third receive treatment, according to the Department of Justice. After their release, they often fare worse. Most recently released inmates from prisons and jails were eligible for Medicaid enrollment under the Affordable Care Act. But now, more than 34 states terminate Medicaid enrollment for those serving time, CNN reported in April. That stigmatization leaves prisoners with mental health disorders like substance abuse with nowhere to go.

"As a society, we do not do enough to rehabilitate formerly incarcerated individuals back into our world," Ranapurwala said in a statement.

Most inmates return to the same environments they left when they were first convicted, and without governmental support or rehabilitation efforts to prevent them from falling back into the same pattern of substance use, the formerly incarcerated rely on friends and family to model their behavior. A National Institute on Drug Abuse study found that ex-inmate's use was strongly predicted by their friends' substance use.

In all 50 states, only Rhode Island's prison system treats opioid-addicted inmates with three medications, which are proven to reduce the mortality rate of opioid addicts by at least 50 percent, while 16 others provide only one and 28 don't offer any medication to addicted prisoners, Vox reported in March.