Paquette Catherine, Ehle Kate, Roach Margaret, Danns Tasia, LeMasters Katherine, Craft Betsy, Brinkley-Rubinstein Lauren
Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27701, USA.
Department of Medicine - Internal Medicine, University of Colorado Anschutz Medical Campus, 13001 East 17 Place, Aurora, CO, 80045, USA.
BMC Glob Public Health. 2025 May 1;3(1):36. doi: 10.1186/s44263-025-00152-y.
In the USA, people with a history of criminalized drug use and drug use disorders reentering the community after incarceration frequently experience adverse health outcomes including overdose, suicide, and infectious disease acquisition. This review presents a conceptual model for understanding risk pathways for these outcomes related to post-release psychosocial needs. We first summarize the literature on post-release needs experienced by people who use criminalized drugs during reentry in multiple domains, including basic needs and those related to relationships as well as medical, mental health, and substance use problems. Drawing from a socioecological model, we demonstrate how vulnerability factors related to criminal legal involvement and criminalized drug use operate at intrapersonal (i.e., individual), interpersonal, institutional, community, and policy levels to negatively affect the ability of people who use drugs to meet each of these types of needs. We present research demonstrating that when people leaving incarceration are met with the overwhelming task of addressing competing demands, they often experience strong negative affect, which can lead to risk-conferring behaviors including criminalized drug use. Competing needs also create environmental conditions that amplify risk. We argue for the importance of interventions that address determinants of post-release health at individual and social-environmental levels to prevent adverse outcomes.
在美国，有吸毒犯罪史且在监禁后重新融入社区的药物使用障碍者经常经历不良健康后果，包括药物过量、自杀和感染疾病。本综述提出了一个概念模型，用于理解与释放后心理社会需求相关的这些后果的风险途径。我们首先总结了关于在重新融入社会期间使用违禁药物者在多个领域释放后需求的文献，包括基本需求、与人际关系相关的需求以及医疗、心理健康和药物使用问题。借鉴社会生态模型，我们展示了与刑事法律介入和违禁药物使用相关的脆弱性因素如何在个人（即个体）、人际、机构、社区和政策层面发挥作用，对吸毒者满足各类需求的能力产生负面影响。我们展示的研究表明，当刑满释放人员面临应对各种相互竞争需求的艰巨任务时，他们往往会产生强烈的负面情绪，这可能导致包括吸毒犯罪在内的风险行为。相互竞争的需求还会营造出加剧风险的环境条件。我们主张在个人和社会环境层面开展干预措施以解决释放后健康的决定因素，从而预防不良后果。
