Utilizing a public health intervention to reduce fatal overdose for unhoused individuals upon release from incarceration in Boston: program reach and outcomes

Citation

Desmarais, J., Chaudhuri. N., Ladner, S., Ayinkamiye, R., Fang, L., Horkenbach, L., McBride, C., Rooney, E., Suyama, E., Bisceglia-Kane, C., Rawlins-Pilgrim, S., & Smith, K., Utilizing a public health intervention to reduce fatal overdose for unhoused individuals upon release from incarceration in Boston: program reach and outcomes. Presentation at BMC Grayken Center Together for Hope Conference, Boston, MA.

 

 

Authors

Jeffrey Desmarais
Sofía Alejandra Ladner
Rolande Ayinkamiye

Background

Recognizing the high prevalence of opioid use disorder (OUD) among incarcerated, homeless individuals and their elevated risk for fatal overdose upon release, Boston Health Care for the Homeless Program (BHCHP) collaborated with two county jails to provide medication for opioid use disorder (MOUD) and related care to people exiting incarceration through their reentry program (RISE). They partnered with the Institute for Community Health (ICH) as their evaluator to assess program outcomes.

Methods

Data Collection

  • Grantees are required to administered the Government Performance and Results Act (GPRA) Client Outcome Measures tool. BHCHP and ICH supplemented this tool with local survey questions.
  • The combined assessment was administered in-person to all participants at baseline, and re-administrated 4-7 months after enrollment (follow-up).

Data Management and Analysis

  • Assessment data was entered into RedCAP, an online web-based survey platform, that served as the project’s data management system
  • ICH conducted a descriptive analysis of key demographics, drug use, and MOUD utilization at baseline.
  • A pre-post analysis was conducted for participants with matched baseline and follow-up data changes in their drug use and MOUD utilization.
  • Patients with and without follow-ups were compared to explore potential disparities in race/ethnicity, age, gender, and MOUD utilization

Results

Discussion

Exiting incarceration is a vulnerable time for people with a history of OUD. RISE participants with matched pre-post data were able to maintain their MOUD utilization and saw lower opioid use compared to their pre incarceration. Further, we saw no differences in follow-up rates when comparing participants with different demographics, mental health statuses and MOUD utilization. These findings suggest that the BHCHP RISE program is effectively engaging patients in MOUD and associated services during a crucial period post-incarceration.