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49 <br /> North Carolinas Experience <br /> "A recent study in North Carolina found that, in the first two weeks after being released from <br /> prison,former inmates were 40 times more likely to die of an opioid overdose than someone in <br /> the general population. <br /> When restricted to heroin overdoses only, formerly incarcerated individuals' likelihood of <br /> overdose death increased to 74 times the norm within the first two weeks after release. Even <br /> an entire year after release,overdose death rates remained 10-18 times higher among formerly <br /> incarcerated individuals as compared to the general N.C. population." <br /> According to Shabbar Ranapurwala, PhD, assistant professor in the Gillings School's <br /> Department of Epidemiology, "Preventing overdose deaths and treating substance use <br /> disorders in formerly incarcerated people may prevent the spread of the epidemic in the general <br /> population." <br /> 'In North Carolina, between 22,000 and 27,000 individuals are released from prison each year. <br /> These individuals are particularly vulnerable to the opioid epidemic for three key reasons. First, <br /> two-thirds of them already have a substance use disorder(which is classified as a mental health <br /> condition....). In fact,many former inmates initially were imprisoned for offenses that stemmed <br /> from substance use. <br /> Second,formerly incarcerated individuals undergo forced withdrawal during incarceration,and <br /> therefore have a very low tolerance when released from prison. Finally, there are few support <br /> systems in place for most inmates upon release —this includes a lack of access to health care. <br /> "A host of other problems like stigmatization, loss of dignity, loss of family for some, and <br /> discrimination in housing and employment only compound existing substance use problems," <br /> Ranapurwala explained. "This leads to premature deaths." <br /> "As a society, we do not do enough to rehabilitate formerly incarcerated individuals back into <br /> our world," he added. "What's more, both medically and scientifically, we know that substance <br /> use disorder is a health condition — an illness."' <br /> (Former inmates at high risk for opioid overdose following prison release,July 19,2018.Gillings <br /> School of Global Public Health communications team. These findings,published online July 19 <br /> by the American Journal of Public Health). <br /> Italics added. <br /> While the exact proportion of residents of North Carolina correctional facilities who have a history of <br /> opioid abuse is unknown, a very high percentage of the nation's prison and jail population suffers from <br /> drug addiction. The Bureau of Justice Statistics (BJS) estimated in 2017 that two-thirds of offenders held <br /> in state prisons and local jails had substance abuse problems. Further, a 2016 study estimated that <br /> between 24 and 36 percent of all opioid-dependent adults cycle in and out of jails each year, <br /> demonstrating the need to break this vicious cycle of dependence, criminal behavior, and incarceration.3 <br /> Reentry Partners, Collaborations and Services:This Collaborative involves five partner organizations, <br /> four of which are relevant to this Orange County proposal. Each partner will assign a Collaborative <br /> Leader/Liaison for its organization.Together,these liaisons will constitute the TSRC leadership team. <br /> 3 https://www.prisonlegalnews.org/news/2019/sep/5/opioid-epidemic-impacts-prisons-and-jails/ <br /> 3 <br />