• Posted April 25, 2024

Drug, Alcohol Abuse Goes Untreated in Many Ex-Prisoners

Most ex-cons are unlikely to receive substance use treatment following their release from prison, even though odds are high they are struggling with addiction, a new study finds.

National estimates suggest as many as 85% of inmates leave prison with some form of substance abuse problem, researchers said.

But only 17% of ex-cons on Medicaid in Virginia have been diagnosed with substance use disorders, and even fewer have been prescribed addiction-fighting medication, investigators found.

“This research shows that many people aren’t getting the medical attention they need as they transition back to their communities,” said lead researcher Peter Cunningham, interim chair of the Virginia Commonwealth University Department of Health Policy.

For the study, researchers used data from Virginia’s health and corrections departments to track the number of people diagnosed and treated for addiction following their release from prison.

More than 4,600 adults were released from county jails and state prisons in 2022, and 85% enrolled in Medicaid within one month of release, the study found.

“The good news is that we see a high number of individuals enrolling in Medicaid soon after they are released from prison, and that is in large part due to the state expanding Medicaid coverage in 2019,” Cunningham said in a university news release.

However, only 17% had seen a doctor and been diagnosed with a substance use disorder within three months of their release, including 13% with an opioid use disorder.

Only about 25% of ex-cons addicted to opioids were prescribed medications to treat their addiction, researchers found -- far less than the 78% of all Medicaid enrollees who received meds after diagnosis with opioid use disorder.

Medications like methadone and buprenorphine can help people with an opioid addiction manage their habit.

“Based on national statistics, we expected more people to receive a diagnosis and treatment for opioid addiction,” Cunningham said. “This is concerning because having an undiagnosed, untreated opioid use disorder greatly increases the risk of overdose.”

Most inmates qualify for Medicaid while incarcerated, but only emergency hospital services are covered as they serve their sentence, researchers noted. Addiction treatment, as well as most other benefits, are prohibited by federal law until after their release.

“The first few months after a person is released from incarceration is a particularly vulnerable time. They often have to figure out all aspects of their life at the same time,” said researcher Hannah Shadowen, a medical/doctoral student at Virginia Commonwealth University’s School of Population Health in Richmond.

“Many people don’t have a stable residence, mailing address or phone number, which makes it difficult for the Medicaid agency to contact them for health services,” Shadowen added in a university news release.

Ex-cons also can face a delay in registering with Medicaid and scheduling an appointment with a doctor, said researcher Sarah Marks, a medical/doctoral student at Virginia Commonwealth.

“Even having the required photo identification and Medicaid card to visit a doctor’s office is going to be much harder to do during this period of tremendous instability,” Marks said.

Researchers now are surveying formerly incarcerated Medicaid patients to figure out the exact barriers they experienced when seeking addiction treatment after prison.

Increasing access to addiction treatment prior to release might be one way to make sure ex-cons are getting the help they need, Cunningham said.

“If providers are able to diagnose substance use disorders and initiate treatment plans before a person is released from prison, this might reduce the risk of overdoses and improve health outcomes when they return to their community,” Cunningham noted.

More information

The National Institute on Drug Abuse has more about addiction treatment.

SOURCE: Virginia Commonwealth University, news release, April 22, 2024