This study assesses the prevalence and risk factors for opioid related mortality (ORM) in a large, urban probation department.
This cross-sectional study estimates the prevalence and risk factors for opioid related mortality (ORM) in a large, urban probation department and finds that elevated risk for ORM among the probation population justifies urgent and data-driven partnerships between public health and community corrections to train probation staff; to identify high-risk clients for evidence-based treatment and overdose prevention strategies; and to institute policies to support and sustain these activities. Opioid overdose deaths on probation are much higher than the general population. Fentanyl is a main driver of overdose deaths in the probation population. Probation client characteristics indicate differential risk of overdose death. Linkages between the justice system and public health can be strengthened. It is known that risk of opioid-related mortality (ORM) is elevated after release from jail and prison, yet there are gaps in knowledge around ORM among people on probation and the relationship of ORM to drug testing and treatment referral while under supervision. Understanding this relationship is critical for probation officers. The authors joined mortality records and probation records for 2018 and 2019 to determine the rate of ORM for the probation population. The authors then stratified ORM rates by risk factors, including demographics, drug testing results, and treatment placements. Individuals on probation were fifteen times more likely to die from ORM than the general county population, largely driven by fentanyl (detected in 86.8% of deaths). Risk was elevated for clients over age 45, clients with at least one positive drug test for opioids or cocaine, and clients with previous placements in drug treatment. Positive urine tests for opioids were associated with 80 times greater risk of ORM than the general population. Although Black clients experienced ORM in greater numbers, white clients had relatively greater ORM risk. (Published Abstract Provided)