Background: Understanding the health conditions of those under carceral control is often made difficult due to lack of access to data. Yet, as has been made clear during the COVID-19 pandemic, is that data is essential to understand the scope of disease and how best to allocate resources. To better understand the needs of criminal legal oriented research and non-profit organizations, we interviewed stakeholders to better understand how they use existing data, what data they lack, and what data they would like to have to optimally assess the health of people who are incarcerated. Results: Stakeholders reported a lack of trust and data availability as key issues. Many perceived the few institutions that do collect and disseminate data as obfuscating data or having a bias in collection and reporting. Additionally, concerns such as balancing the interest of systems-impacted people with advocacy were described as concerning for participants. Conclusions: To tackle these issues of transparency and availability, the authors believe that an independent oversight body could be instrumental to ensuring accurate and timely data collection and reporting. As many participants turned to creating their own data, coalition building could be influential as a large network of resources may support capturing the varied experiences of people who are incarcerated.

This cross-sectional study collects data on US prison policies concerning organ donation by incarcerated individuals.

Background: Standards of care for pregnant persons with opioid use disorder (OUD) have been published across multiple institutions specializing in obstetrics and addiction medicine. Yet, this population faces serious barriers in accessing medications for OUD (MOUD) while incarcerated. Therefore, we examined the availability of MOUD in jails. Methods: A Cross-sectional survey of jail administrators (n=371 across 42 states; 2018–2019) was conducted. Key indicators for this analysis include pregnancy testing at intake, number of county jails offering methadone or buprenorphine to pregnant incarcerated persons for detoxification on admission, continuation of pre-incarceration treatment, or linkage to post-incarceration treatment. Analyses were performed using SAS. Findings: Pregnant incarcerated persons had greater access to MOUD than non-pregnant persons (χ2=142.10, p<0.0001). Larger jurisdiction size and urban jails were significantly more likely to offer MOUD (χ2=30.12, p<0.0001; χ2=26.46, p

People who live and work in carceral settings are at high risk for COVID-19. As of September 30, 2022, at least 622 968 people incarcerated in US prisons and 230 168 staff members had been diagnosed with COVID-19, and 3185 had died. Compared with rates among the general population, average COVID-19 case rates in state and federal prisons are five times higher and mortality rates are at least double. Likewise, communities that are near correctional facilities have higher rates of COVID-19. Carceral systems, however, have not been fully integrated into public health responses to the pandemic. Few local governments have incorporated jails and prisons into their strategies for COVID-19 response and preparedness. The World Health Organization’s recent comprehensive framework for COVID-19 response recommends that all countries conduct a substantive equity and inclusion analysis to inform programming, which should rely on “meaningful participation, collaboration, and consultation with subpopulations experiencing poverty and social exclusion.” Yet, the bulk of what has been written on prisons during this pandemic has been based on an external “expert” perspective, not grounded in the perspective of people who live and work in these environments. We report on lessons learned in the first two years of the pandemic that were gleaned from a unique partnership with three carceral systems and based on 100 interviews we conducted with incarcerated people, correctional workers, and medical staff. They point to unique structural and operational challenges that carceral facilities face in prioritizing the goal of COVID-19 mitigation and highlight strategies that may improve pandemic preparedness. The methods of our study that generated these findings can be viewed in the Appendix (available as a supplement to the online version of this article at https://ajph.org). From this work, five dominant themes emerged that provide an “on-the-ground” perspective of living through COVID-19 in carceral settings and center the voices of those incarcerated and working in carceral spaces to capture the complexity of COVID-19 prevention and mitigation.

Introduction: In recent years, there has been a dramatic increase in overdose deaths involving illicitly manufactured fentanyl. The risk of death due to fentanyl exposure is far higher for people without adequate tolerance, such as those being released from incarceration. However, little is known about knowledge and perceptions of fentanyl among people who are incarcerated. Methods: We conducted 40 semi-structured qualitative interviews with people who were incarcerated at the Rhode Island Department of Corrections (RIDOC). We explored the impressions of, preferences for and experiences with fentanyl among these people. Analysis employed a general, inductive approach using NVivo 12. Results: We found that a majority of the participants were familiar with fentanyl, sought to avoid it and utilized harm reduction techniques when using drugs and taking treatment with medication for opioid use disorder (MOUD) to reduce their risk of overdose. Discussion: Our findings suggest that broad access to MOUD, especially for incarcerated people, is increasingly necessary in the era of fentanyl, both to aid people seeking recovery due to the increased overdose risk of drug use and to reduce overdose morbidity for people who use drugs.