SAFE GC Coalition: Income Loss, Jail Linked to Opioid Epidemic

Research has demonstrated that the increasing number of deaths from drug use in the United States has been linked with a surge in the distribution of prescription painkillers. New research suggests that when incarceration rates rise and household incomes fall, drug-related deaths increase, according to a study published in the medical journal Lancet Public Health.

The study found that from 1983 to 2014, when there was a large decrease in average household income (nearly a third) there was an associated 12.8% increase in drug-related deaths in the county.

Researchers maintain that in general, we know that most incarceration is only very loosely related to the crime rate and that if incarcerating people because we don't like the negative effects of drugs, what this study shows is it's counterproductive. It's a strong argument for medicalization of hard drugs as opposed to criminalization, which actually makes a lot of sense, given that the definition used for addiction is the continued obsessive-compulsive use of drugs despite negative consequences.

In total, the new study included data for 2,640 counties in the United States between 1983 and 2014. Separate research previously has shown that drug-related deaths across counties between 1980 and 2014 climbed overall by more than 600%

The study involved analyzing mortality data from the U.S. National Vital Statistics System and Institute for Health Metrics and Evaluation, household income data from the US Census Bureau, and incarceration data by county from the Vera Institute of Justice.

As an additional variable, the researchers obtained county-level data on retail opioid prescription rates between 2006 and 2014 from the Center for Disease Control. They found that the incarceration rates were significantly associated with overdose deaths even after controlling for local opioid prescription rates since 2006.

On average, 130 people in the United States die every day from an opioid overdose, according to the Center for Disease Control.

Researchers stated the most surprising thing was that the prescriptions of the opioids do not seem to be the major cause of the opioid crisis. It's contributing for sure but once controls were put in place , it had no predictive power.

Typically, the national dialogue on opioid addiction is all focused on the behavior of the pharmaceutical companies but it's all focused on the supply and no focus on the demand adding that one limitation of the new study is that the prescription data only dated back to 2006.

The study had some other limitations, including that the findings only suggest an association between reduced household incomes, high incarceration rates and drug-related deaths. More research is needed to determine whether a causal relationship exists between those factors, and to explain why the complex associations exist. The impact of incarceration on individuals and families can be devastating leading to an increased incidence of homelessness, unemployment, divorce, and recidivism. Individuals who have been incarcerated are more likely to be substance users and have a higher risk of premature death.

Economic deprivation is also a known risk factor for substance abuse and early death. It seems plausible, therefore, that both rates of incarceration and impoverishment might contribute to changes in mortality from drug use. The results of this study highlight the need to evaluate current approaches towards the issues associated with incarceration.