Correlates of Post-Release Overdose Among Women With Opioid Use Disorder Returning to the Community Following Jail Incarceration.

BACKGROUND: Previous research indicates that opioid overdose risk is significantly higher during community reentry following incarceration, particularly for women. However, there is a limited understanding of factors specifically associated with women's overdose risk post-jail release. This study examines the relationship between individual risk factors, structural vulnerabilities, and nonfatal overdose during the 3 months following jail release among a sample of women with opioid use disorder (OUD). METHODS: Women (N = 900) in this study were randomly selected from 9 Kentucky jails, screened for OUD, and interviewed as part of the Justice Community Opioid Innovation Network trial (NCT04069624) funded by the National Institute on Drug Abuse. The sample consisted of women who completed the 3-month follow-up interview post-release and had complete data on all variables of interest (n = 754). Bivariate analyses assessed relationships between post-release nonfatal overdose and individual-level factors (eg, demographic characteristics) and structural vulnerabilities (eg, unstable housing and food insecurity). Firth logistic regression was then used to further examine independent correlates of nonfatal overdose during community reentry. RESULTS: According to analyses, 31 women (4.1%) reported a nonfatal overdose during the 3 months post-jail release. Regression results indicated that odds of overdosing post-release were higher for women who had overdosed previously in their lifetime (P = .004). Injection drug use (P < .001) and unstable housing (P = .048) during the follow-up period also increased the odds of overdose. CONCLUSIONS: These results suggest that both individual risk factors and structural vulnerabilities may contribute to increased overdose risk for women with OUD returning to the community post-incarceration. Overdose prevention interventions should include strategies for mitigating these reentry challenges. CLINICAL TRIALS INFORMATION: ClinicalTrials.gov ID NCT04069624; https://clinicaltrials.gov/study/NCT04069624.