Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states
Abstract Background Opioid-related overdose is the leading cause of mortality among individuals recently released from incarceration in the U.S. Naloxone is an FDA-approved opioid antagonist medication designed to rapidly reverse opioid overdose. Despite evidence of its acceptability and effectivene...
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2025-07-01
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| author | Timothy Hunt Carrie B. Oser Peter D. Friedmann Nicole Mack Peter Balvanz Bridget Freisthler Redonna K Chandler Karli Hochstatter Daniel R. Harris LaShawn Glasgow Lauren D’Costa Mary R. Russo Barry Eggleston Arnie Aldridge Paul Bellair Allyson G. Cogan James L. David Nabila El-Bassel Dawn Goddard-Eckrich Steve Gomori Holly Hagan Steve Hanson JaNae Holloway Elizabeth N. Kinnard Charlie Knott Michael W. Konstan Sharon L. Walsh Patricia A. LeBaron Michael S. Lyons Margaret McGladrey Joan Papp Sean M. Murphy Sandra Springer Emmanuel Oga Michele Staton Elizabeth Schady Fernando Montero Hilary L. Surratt Danelle Stevens-Watkins John Winhusen Gary A. Zarkin Greer A. Hamilton Joel G. Sprunger |
| author_facet | Timothy Hunt Carrie B. Oser Peter D. Friedmann Nicole Mack Peter Balvanz Bridget Freisthler Redonna K Chandler Karli Hochstatter Daniel R. Harris LaShawn Glasgow Lauren D’Costa Mary R. Russo Barry Eggleston Arnie Aldridge Paul Bellair Allyson G. Cogan James L. David Nabila El-Bassel Dawn Goddard-Eckrich Steve Gomori Holly Hagan Steve Hanson JaNae Holloway Elizabeth N. Kinnard Charlie Knott Michael W. Konstan Sharon L. Walsh Patricia A. LeBaron Michael S. Lyons Margaret McGladrey Joan Papp Sean M. Murphy Sandra Springer Emmanuel Oga Michele Staton Elizabeth Schady Fernando Montero Hilary L. Surratt Danelle Stevens-Watkins John Winhusen Gary A. Zarkin Greer A. Hamilton Joel G. Sprunger |
| author_sort | Timothy Hunt |
| collection | DOAJ |
| description | Abstract Background Opioid-related overdose is the leading cause of mortality among individuals recently released from incarceration in the U.S. Naloxone is an FDA-approved opioid antagonist medication designed to rapidly reverse opioid overdose. Despite evidence of its acceptability and effectiveness at reducing the risk of opioid overdose death after release from incarceration, only an estimated 25% of US jails provide naloxone upon release. This study examines the effectiveness of the HEALing Communities Study (HCS) Communities That HEAL (CTH) intervention on enhancing access to overdose education and naloxone distribution (OEND) in participating jails in Kentucky, New York, Massachusetts, and Ohio. Methods Communities were randomized to intervention (n = 34) or wait-list control (n = 33) arms stratified by state. Jail-based surveys (n = 59) were implemented at three time points during 2019 to 2022. Generalized linear mixed models (GLMM) with imputation captured intervention effects during the evaluation period (July 1, 2021-June 30, 2022). Interpretation of results was informed by the Practical, Robust Implementation and Sustainability Model framework. Results The CTH intervention was significantly associated with the hypothesized outcome, resulting in a greater number of jails providing overdose education (H1, relative riskAdj = 1.51 [95% CI: 1.09, 2.08], p = 0.013) and the number of jails providing naloxone upon release (H2, relative riskAdj = 1.49 [95% CI: 1.05, 2.13)], p = 0.027). External factors related to OEND implementation, such as correctional health care models, available resources, and state COVID restrictions, varied across communities. Conclusions The CTH intervention engaging community coalitions to deploy evidence-based practices was effective in increasing OEND implementation in jails, helping address elevated overdose risks for individuals during and post-release from incarceration. Partnerships between state, community, and jail-based stakeholders are needed to assure expanded access to this lifesaving, evidence-based approach. |
| format | Article |
| id | doaj-art-c5a164b78d1d4e0ea4dd80369c9fe2d1 |
| institution | DOAJ |
| issn | 2194-7899 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Health & Justice |
| spelling | doaj-art-c5a164b78d1d4e0ea4dd80369c9fe2d12025-08-20T03:04:22ZengBMCHealth & Justice2194-78992025-07-0113111210.1186/s40352-025-00353-5Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 statesTimothy Hunt0Carrie B. Oser1Peter D. Friedmann2Nicole Mack3Peter Balvanz4Bridget Freisthler5Redonna K Chandler6Karli Hochstatter7Daniel R. Harris8LaShawn Glasgow9Lauren D’Costa10Mary R. Russo11Barry Eggleston12Arnie Aldridge13Paul Bellair14Allyson G. Cogan15James L. David16Nabila El-Bassel17Dawn Goddard-Eckrich18Steve Gomori19Holly Hagan20Steve Hanson21JaNae Holloway22Elizabeth N. Kinnard23Charlie Knott24Michael W. Konstan25Sharon L. Walsh26Patricia A. LeBaron27Michael S. Lyons28Margaret McGladrey29Joan Papp30Sean M. Murphy31Sandra Springer32Emmanuel Oga33Michele Staton34Elizabeth Schady35Fernando Montero36Hilary L. Surratt37Danelle Stevens-Watkins38John Winhusen39Gary A. Zarkin40Greer A. Hamilton41Joel G. Sprunger42Columbia University School of Social WorkDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyBaystate Health and University of Massachusetts Chan Medical School- BaystateRTI InternationalGeneral Internal Medicine, Boston Medical CenterOhio State UniversityNational Institutes of HealthFriends Research InstituteCollege of Pharmacy, University of KentuckyRTI InternationalRTI InternationalColumbia University School of Social WorkRTI InternationalRTI InternationalOhio State UniversityGeneral Internal Medicine, Boston Medical CenterColumbia University School of Social WorkColumbia University School of Social WorkColumbia University School of Social WorkRTI InternationalNew York UniversityAll Rise Treatment Court InstituteRTI InternationalGeneral Internal Medicine, Boston Medical CenterRTI InternationalCase Western Reserve UniversityDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyRTI InternationalOhio State UniversityDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyCase Western Reserve UniversityWeill Cornell Medical CollegeYale School of MedicineRTI InternationalDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyHealth Research, Inc.Columbia University School of Social WorkDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyDepartment of Behavioral Science, Center on Drug & Alcohol Research, Center for Health, Engagement and Transformation, University of KentuckyUniversity of Cincinnati College of MedicineRTI InternationalSchool of Social Work, University of MichiganUniversity of Cincinnati College of MedicineAbstract Background Opioid-related overdose is the leading cause of mortality among individuals recently released from incarceration in the U.S. Naloxone is an FDA-approved opioid antagonist medication designed to rapidly reverse opioid overdose. Despite evidence of its acceptability and effectiveness at reducing the risk of opioid overdose death after release from incarceration, only an estimated 25% of US jails provide naloxone upon release. This study examines the effectiveness of the HEALing Communities Study (HCS) Communities That HEAL (CTH) intervention on enhancing access to overdose education and naloxone distribution (OEND) in participating jails in Kentucky, New York, Massachusetts, and Ohio. Methods Communities were randomized to intervention (n = 34) or wait-list control (n = 33) arms stratified by state. Jail-based surveys (n = 59) were implemented at three time points during 2019 to 2022. Generalized linear mixed models (GLMM) with imputation captured intervention effects during the evaluation period (July 1, 2021-June 30, 2022). Interpretation of results was informed by the Practical, Robust Implementation and Sustainability Model framework. Results The CTH intervention was significantly associated with the hypothesized outcome, resulting in a greater number of jails providing overdose education (H1, relative riskAdj = 1.51 [95% CI: 1.09, 2.08], p = 0.013) and the number of jails providing naloxone upon release (H2, relative riskAdj = 1.49 [95% CI: 1.05, 2.13)], p = 0.027). External factors related to OEND implementation, such as correctional health care models, available resources, and state COVID restrictions, varied across communities. Conclusions The CTH intervention engaging community coalitions to deploy evidence-based practices was effective in increasing OEND implementation in jails, helping address elevated overdose risks for individuals during and post-release from incarceration. Partnerships between state, community, and jail-based stakeholders are needed to assure expanded access to this lifesaving, evidence-based approach.https://doi.org/10.1186/s40352-025-00353-5Opioid epidemicNaloxone distributionOverdose educationJailCarceral settings |
| spellingShingle | Timothy Hunt Carrie B. Oser Peter D. Friedmann Nicole Mack Peter Balvanz Bridget Freisthler Redonna K Chandler Karli Hochstatter Daniel R. Harris LaShawn Glasgow Lauren D’Costa Mary R. Russo Barry Eggleston Arnie Aldridge Paul Bellair Allyson G. Cogan James L. David Nabila El-Bassel Dawn Goddard-Eckrich Steve Gomori Holly Hagan Steve Hanson JaNae Holloway Elizabeth N. Kinnard Charlie Knott Michael W. Konstan Sharon L. Walsh Patricia A. LeBaron Michael S. Lyons Margaret McGladrey Joan Papp Sean M. Murphy Sandra Springer Emmanuel Oga Michele Staton Elizabeth Schady Fernando Montero Hilary L. Surratt Danelle Stevens-Watkins John Winhusen Gary A. Zarkin Greer A. Hamilton Joel G. Sprunger Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states Health & Justice Opioid epidemic Naloxone distribution Overdose education Jail Carceral settings |
| title | Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states |
| title_full | Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states |
| title_fullStr | Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states |
| title_full_unstemmed | Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states |
| title_short | Overdose education and naloxone distribution in jails: Examining the impact of the Communities That HEAL intervention in 4 states |
| title_sort | overdose education and naloxone distribution in jails examining the impact of the communities that heal intervention in 4 states |
| topic | Opioid epidemic Naloxone distribution Overdose education Jail Carceral settings |
| url | https://doi.org/10.1186/s40352-025-00353-5 |
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