To Reduce Opioid Overdoses, Rutgers Researchers Studying Treatment Strategies for Released Prisoners with Substance Use Disorders

Improved programs will help everyone by reducing crime and costs while making communities safer

Decades into the opioid epidemic that has created so many challenges for New Jersey communities, Rutgers researchers are studying promising avenues for improving post-release outcomes and community re-integration for released prisoners with substance use disorders. The effort focuses on initiating medications for opioid use disorder (OUD) prior to release and providing peer navigation during the community re-entry process.

Funded by an approximately $700,000 grant from the National Institute of Drug Abuse, the five-year-study will assess the impact of these interventions on re-entry outcomes, including non-fatal and fatal overdoses, engagement in treatment following release, and other aspects of successful community re-integration and avoidance of re-offense and re-incarceration.

Despite small, recent, national reductions in fatal overdoses, the overdose epidemic has continued to ravage the nation and New Jersey, with more than 100,000 drug overdoses nationally in 2023 and more than 2,500 in New Jersey, according to provisional data from the Centers for Disease Control. Among the populations that are at the highest risk for relapse and overdose are individuals with opioid use disorder who are newly released from prison. Without larger-scale interventions to support recovery for released prisoners in states across the nation, the costs of relapse for individuals and communities will be profound, especially given the widespread availability of fentanyl and lethal cocktails of other substances within the illicit drug supply.

New Jersey has been a leader for innovative initiatives to prepare state prisoners with OUD for release and then support their recovery during re-entry, with programs that could become a national model. Starting in 2017, New Jersey implemented a program of pre-release treatment and peer navigation across all 11 of its state prisons, providing Rutgers Health direct access to a unique, readily available research environment.

“It’s important to understand that treatment is prevention – one of our goals is to identify the most effective strategies for taking people out of the active pool of users,” said Stephen Crystal, who directs the Center for Health Services Research, part of the Rutgers Institute for Health, Health Care Policy and Aging Research, and is leading the study. “By stabilizing an individual on appropriate medication prior to their release, you’re ensuring they approach re-entry with experience with their meds, thus improving their chances for follow-through with treatment when they’re no longer incarcerated.”

Crystal, Board of Governors Professor of Health Services Research and Distinguished Research Professor with the Rutgers School of Social Work, added that peer navigation – the concept of individuals in recovery during re-entry being supported through enrollment in an active service network – also is extremely effective.

The study also will assess the degree to which social and racial inequities are contributors to the situation. Study partners include Dr. Peter Treitler, an alumnus of the Social Work PhD program at Rutgers who is now Assistant Professor at Boston University School of Social Work, and Dr. Grant Victor, Assistant Professor at the Rutgers School of Social Work.

“This study is part of many projects now underway to help us better understand causes of and solutions to the opioid epidemic,” Crystal said. “Reducing the toll of overdoses and supporting recovery can seem daunting, but there’s no inevitability to the unacceptable overdose rates we are experiencing, which are particularly severe following release from prison. New Jersey’s innovative interventions are promising ways to intervene at the correct time and provide effective support.”