Opioid overdose peer prevention: The power of inmate-led overdose prevention in correctional settings

Opioid overdose in Massachusetts is now the leading cause of injury death, surpassing motor vehicle accidents. High risk populations are especially vulnerable to overdose, including individuals experiencing homelessness, and those recently released from detox or prison. One study in 2007 in NEJM showed that former inmates were 129 times more at risk for overdose mortality than the general population, with the highest risk of death within the first 2 weeks of release. In one Boston House of Corrections, surveys of inmates incarcerated on a substance abuse unit revealed that 19% had experienced a non-fatal overdose, while 38% had witnessed an overdose in their lifetime. Of the 19% who experienced overdose, 26% did so within 7 days of release – and half of those, more than once within 7 days of release. Reaching inmates with overdose prevention information and resources, prior to release and when they are most receptive to hearing prevention messages, is an urgent public health priority. This presentation will describe the innovative collaboration between a community substance abuse coalition and an urban House of Correction to reach high risk inmates prior to release. A uniquely developed 6-week curriculum that engages inmates to teach each other will be described. Survey outcomes highlight the power and efficacy of inmate-led education. Overdose can be prevented, or reversed while it is happening – and those most at risk are best positioned to share life-saving information. Survey outcomes, anecdotes and lessons learned will be presented.