A large number of former incarcerated Virginians have substance use disorders, but few receive treatment after they are released.
Virginia Commonwealth University’s School of Population Health is leading research that may shed light on the health disparities of former inmates and what might help them receive lifesaving care.
Among the possibilities for a better return to the community, researchers say, might be for inmates to receive addiction treatment while incarcerated, something currently prohibited by federal law.
National estimates suggest as many as 85 percent of people who are incarcerated have substance use disorders.
While most of these adults are eligible for Medicaid services after their release, the VCU-led study found that only 17 percent of formerly incarcerated Medicaid members were diagnosed with substance use disorders in Virginia. Even fewer received medications as treatment for their addiction.
“We know that substance use disorders are prevalent health issues among incarcerated populations, but this research shows that many people aren’t getting the medical attention they need as they transition back to their communities,” said Peter Cunningham, Ph.D., who led the new research and is interim chair of the Department of Health Policy at VCU’s School of Population Health.
“The good news is that we see a high number of individuals enrolling in Medicaid soon after they are released from prison, and that is in large part due to the state expanding Medicaid coverage in 2019,” Cunningham said. “However, based on national statistics, we expected more people to receive a diagnosis and treatment for opioid addiction. This is concerning because having an undiagnosed, untreated opioid use disorder greatly increases the risk of overdose.”
The researchers are trying to understand the barriers that the recently incarcerated individuals may be facing that is preventing them from getting care.
“The first few months after a person is released from incarceration is a particularly vulnerable time. They often have to figure out all aspects of their life at the same time,” said Hannah Shadowen, a student at VCU’s School of Population Health and contributor to the report.
“Many people don’t have a stable residence, mailing address or phone number, which makes it difficult for the Medicaid agency to contact them for health services.”
The researchers say that increasing access to treatment prior to release could help facilitate transitions to the community.
While the majority of individuals in the criminal justice system qualify for Medicaid, only emergency hospital services are currently covered as they serve their sentence.
Most other benefits – including treatments for substance use disorders – are prohibited by federal law until after a person is released from prison.
“If providers are able to diagnose substance use disorders and initiate treatment plans before a person is released from prison, this might reduce the risk of overdoses and improve health outcomes when they return to their community,” said Cunningham.
The report
The study is in collaboration with the Virginia Department of Medical Assistance Services.
Using data from both DMAS and the Virginia Department of Corrections, the researchers measured the number of people being diagnosed and treated for a substance use disorder following their release from prison.
Analysis by VCU research team
- 4,652 adults were released from county jails and state prisons in 2022
- 85 percent of those released enrolled in Medicaid within one month
- Among those enrolled in Medicaid, only 17 percent had seen health care providers and were diagnosed with a substance use disorder within three months, including 13 percent with an opioid use disorder.
- Of those who were formerly incarcerated and diagnosed with an opioid use disorder, only about 25 percent went on to receive medications to treat their addiction. By comparison, 78 percent of all Medicaid members diagnosed with an opioid use disorder in Virginia received medications.
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Crystal Graham
