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Drug Use in the Year After Prison

September 30, 2019

Bruce Western (Columbia University) and Jessica Simes (Boston University) are the co-authors of a new article, “Drug Use in the Year After Prison,” which appears in a recent issue of Social Science & MedicineThis research article uses data from the Boston Reentry Study, a unique longitudinal study that follows 122 men and women in the year after their release from prison. Co-funded by the Russell Sage Foundation and the W.K. Kellogg Foundation, the study was also the basis for Western’s RSF book, Homeward: Life in the Year After Prison (2018). Homeward won the 2019 Outstanding Book Award from the Inequality, Poverty, and Mobility Section of the American Sociological Association.  Bruce Western has received RSF grant support for his groundbreaking research on mass incarceration and social and economic inequality. He is also the author of the RSF book Punishment and Inequality in America (2006), and co-editor, with David Grusky and Christopher Wimer, of The Great Recession (2011).

Western and Simes’ study of drug use among the formerly incarcerated is distinguished by the fact that it tracks both illegal and legal drug use in order to better understand social integration after incarceration. The use of illegal drugs is a negative social indicator that suggests ongoing criminal behavior and may prompt a relapse into substance abuse addiction while the use of medications indicates continued access to medical care. Studying the use of both illegal drugs and legal medications is important as this population is unusually burdened by high rates of infectious disease, chronic conditions, substance abuse, and mental illness. 

Figure 1 (below) charts the proportion of survey respondents who reported using hard drugs, cannabis, mental health medication, and pain medication during interviews taken at four intervals after their release from prison. The results show that hard drug use is mostly confined to those who have a previous history of drug and alcohol problems. The rates of mental health medication use increase significantly over the year after incarceration.

The authors’ findings indicate that childhood trauma, a history of drug or alcohol problems, and poor mental health are risk factors for illicit drug use while the odds of hard drug use are lower among those receive housing or financial help from their families. The authors also demonstrate that the wide availability of Medicaid (Massachusetts expanded Medicaid eligibility in 2006 for low-income single men) reduces the likelihood of self-medication with illegal drugs. The latter finding suggests that expanding access to health care may reduce illicit drug use and promote the social integration of the formerly incarcerated. 

Western and Simes’ study is an important intervention in the field, offering new insights about how to integrate the formerly incarcerated into society. 

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