(New York, USA) – Almost 2.3 million people are confined in prisons and jails in the United States, where social distancing to prevent the spread COVID-19 is functionally impossible. While attention has been focused on New York City as one of the hardest hit areas in the world, the infection rate at Riker’s Island is almost six times higher than the surrounding city.
As the number of confirmed cases of COVID-19 in prisons and jails continues to soar, state and local governments have begun to release people from incarceration. In virtually every state, there has been some state or local-level action to try and reduce the numbers of the incarcerated. This progress is to be celebrated even as we recognize that decarceration is only one part of the solution.
“We applaud cities and states that are doing everything they can to release people from behind bars to prevent a prison pandemic,” said Daliah Heller, Director of Drug Use Initiatives at Vital Strategies. “The other critical step is ensuring we have thoughtful reentry programs and strategies, to reduce the spread of COVID-19 and overdose deaths among those released.”
The sweeping impacts of COVID-19 intensify the already-existing reentry challenges for individuals leaving prison and jail, including heightened vulnerability to fatal overdose. A reasoned and humane decarceration process must include comprehensive reentry planning that addresses housing, access to healthcare, and economic support in the face of pervasive hardship and disruption resulting from the COVID-19 outbreak.
Vital Strategies highlights the following essential elements of reentry planning in the context of COVID-19 and overdose prevention.
- Ensuring a safe place to stay and to physically distance.
Housing is among the most significant challenges for people reentering society from a custodial setting under normal circumstances. Reentry planning must take into account that many shelters are closed, and congregate settings such as halfway houses pose a serious risk of COVID-19 transmission. Moreover, individuals released from facilities where COVID-19 exposure has occurred may need to quarantine for 14 days to ensure they are symptom-free.
- Continued access to medications for opioid use disorder.
Continuity of the agonist medications methadone and buprenorphine is an essential and life-saving intervention. People leaving jails and prisons should receive a take-home supply of medication, as well as robust linkage to other health and social supports, including harm reduction services.
- Access to technology and communications equipment to fully benefit from telehealth and telephonic medication prescribing.
Released individuals should be provided with access to a pre-paid cell phone service or assistance with referral to the FCC’s Lifeline (Obama Phone) service. Phone access is essential for ensuring people can fully benefit from telehealth and/or telephonic services for the evaluation and treatment of patients with substance use disorder, which has been facilitated and recommended by the federal government in the face of the COVID-19 outbreak.
- Distribution of the overdose antidote naloxone.
Anyone leaving a prison or jail should receive naloxone under normal circumstances, and releases as part of the COVID-19 response are no different.
- Adjusting community supervision requirements to minimize in-person contacts and reincarceration.
In-person reporting requirements, including drug screening, needlessly put people as risk and contradict physical distancing recommendations. Supervision should be adjusted to avoid these unnecessary contacts and reduce or eliminate incarceration as a sanction for supervision violations.
- Economic stability and support for people reentering communities.
People leaving prison and jail face significant barriers to employment. The COVID-19 outbreak has further contributed to financial instability and disruption. At the time of release, individuals should be equipped with information resources and referrals for financial support, SNAP, and other benefits.
As jurisdictions implement comprehensive reentry support, they must also continue to intervene at the front end of the criminal legal system to prevent incarceration in the first place, and to reduce the risk of COVID-19 infection within correctional settings.
“Governments need to stop arresting people for low-level and non-violent offenses, which contribute to “churn” in jails and heighten the risk COVID-19 transmission both inside and out in the community,” said Heller. “This means halting the incarceration of people for violating the conditions of their supervision, and considering the risk of COVID-19 infection when determining bail. These and other strategies will save lives.”
About Vital Strategies
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible.
About the Overdose Prevention Program
In November 2018, Bloomberg Philanthropies announced a $50 million investment to address the country’s overdose crisis. The initiative—a first-of-its-kind partnership between Vital Strategies, Pew Charitable Trusts, CDC Foundation, and Johns Hopkins Bloomberg School of Public Health—is helping up to 10 states implement solutions over three years to strengthen and scale up evidence-based, data-driven interventions to reduce risks of overdose and save lives.
To find out more, please visit: https://www.vitalstrategies.org/programs/overdose-prevention/
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