Controlled Substances

A newly released report from the United States Department of Justice indicates that among all state and federal prisoners, nearly four in 10 self-reported using drugs and three in 10 self-reported consuming alcohol, at the time of the offense for which they are currently serving a sentence in a correctional facility. Many of those individuals meet the clinical definition of having a substance or alcohol use disorder - 40% for substance use and just over 20% for alcohol. Of that population, 33% of state and 46% of federal prisoners, who met the criteria for having a substance or alcohol use disorder, reported participating in a treatment program after their admission to a correctional facility....

Newly incarcerated individuals who use substances require medical intervention to mitigate the effects of withdrawal symptoms and prevent death, suicide, and injury while in custody. Recent data show that nearly two thirds of sentenced individuals in jails meet the criteria for drug dependence or abuse. LAPPA’s Model Withdrawal Management Protocol in Correctional Settings Act requires evidence-based treatment of substance use disorders, including the use of FDA-approved medications; requires correctional settings to establish and implement administrative and clinical protocols when detaining individuals at risk of withdrawal; and provides state legislators, policymakers, and those in the correctional and health care professions with a comprehensive framework to better respond to withdrawal symptoms and related mental health crises of individuals in custody to decrease their mortality while in correctional settings. ...

One of the ways in which jurisdictions are combating the epidemic of drug overdoses in communities is through the use of “spike alerts,” that is, targeted messages that notify recipients that there is an unexpected increase in drug-related overdoses in a specific area. The purpose of these notifications is to “reduce injury or death from opioid overdoses during spike events.” ...

Since the late 1990s, the United States has outpaced every other country in per capita opioid consumption. Most research suggests that high levels of prescription opioid consumption in the United States have contributed to the current epidemic of opioid misuse and overdose deaths; a review of the scientific literature through February 2020 on international opioid consumption and prescribing practices points to several possible underlying reasons explaining the difference in opioid consumption per capita in the United States....

In recent years, some states have enacted Good Samaritan and Naloxone Access laws to help reduce overdose deaths and respond to opioid overdoses.The Comprehensive Addiction and Recovery Act of 2016 included a provision for GAO to review these laws. This report addresses the following: (1) the efforts ONDCP has taken to collect and disseminate information on Good Samaritan and Naloxone Access laws, (2) the extent to which states, territories, and D.C. have these laws and the characteristics of them, and (3) what research indicates concerning the effects of Good Samaritan laws.To answer these questions, GAO collected and reviewed ONDCP documents and interviewed agency officials. GAO also reviewed and analyzed selected characteristics of jurisdictions' Good Samaritan and Naloxone Access laws. Further, GAO conducted a literature review of empirical studies published from 2010 through May 2020 that examined the effects of Good Samaritan laws....