Email updates

Keep up to date with the latest news and content from Addiction Science & Clinical Practice and BioMed Central.

Open Access Highly Accessed Research

Return to drug use and overdose after release from prison: a qualitative study of risk and protective factors

Ingrid A Binswanger12*, Carolyn Nowels3, Karen F Corsi4, Jason Glanz56, Jeremy Long78, Robert E Booth9 and John F Steiner10

Author Affiliations

1 Division of General Internal Medicine and Division of Substance Dependence, University of Colorado School of Medicine, Mail Stop B180, 12631 East 17th Avenue, Aurora, CO 80045, USA

2 Denver Health Medical Center, 501 East 28th Street, Denver, CO 80045, USA

3 Division of General Internal Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 East 17th Avenue, Aurora, CO 80045, USA

4 Division of Substance Dependence, University of Colorado School of Medicine, 1741 Vine Street, Denver, CO 80206, USA

5 Institute for Health Research, Kaiser Permanente Colorado, 10065 East Harvard Avenue, #300, Denver, CO 80231, USA

6 Department of Epidemiology, Colorado School of Public Health, 13001 East 17th Place, Mail Stop B119, Aurora, CO 80045, USA

7 Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA

8 Division of General Internal Medicine, University of Colorado School of Medicine, Mail Stop B180, 12631 East 17th Avenue, Aurora CO 80045, USA

9 Division of Substance Dependence, University of Colorado School of Medicine, 1741 Vine Street, Denver, CO 80206, USA

10 Institute for Health Research, Kaiser Permanente Colorado, 10065 East Harvard Avenue, #300, Denver, CO 80231, USA

For all author emails, please log on.

Addiction Science & Clinical Practice 2012, 7:3  doi:10.1186/1940-0640-7-3

Published: 15 March 2012

Abstract

Background

Former inmates are at high risk for death from drug overdose, especially in the immediate post-release period. The purpose of the study is to understand the drug use experiences, perceptions of overdose risk, and experiences with overdose among former prisoners.

Methods

This qualitative study included former prison inmates (N = 29) who were recruited within two months after their release. Interviewers conducted in-person, semi-structured interviews which explored participants' experiences and perceptions. Transcripts were analyzed utilizing a team-based method of inductive analysis.

Results

The following themes emerged: 1) Relapse to drugs and alcohol occurred in a context of poor social support, medical co-morbidity and inadequate economic resources; 2) former inmates experienced ubiquitous exposure to drugs in their living environments; 3) intentional overdose was considered "a way out" given situational stressors, and accidental overdose was perceived as related to decreased tolerance; and 4) protective factors included structured drug treatment programs, spirituality/religion, community-based resources (including self-help groups), and family.

Conclusions

Former inmates return to environments that strongly trigger relapse to drug use and put them at risk for overdose. Interventions to prevent overdose after release from prison may benefit from including structured treatment with gradual transition to the community, enhanced protective factors, and reductions of environmental triggers to use drugs.

Keywords:
Drug use; Overdose; Prisoners; Relapse; Prison re-entry