Opioid Misuse and Associated Health Risks among Adults on Probation and Parole: Prevalence and Correlates 2015-2020.

BACKGROUND: As state legislatures work to reduce prison populations and increase the use of community-based alternatives, limited knowledge exists about the service needs of those under criminal justice supervision in the community. Preliminary research indicates unusually high rates of disease, disability, and death. Health risks for this population include opioid misuse, a form of substance misuse that has reached epidemic proportions in the U.S. Evidence indicates this may be one of multiple epidemics this population experiences, complicating intervention. METHODS: Our study included 5154 individuals on probation or parole. Using 2015-2020 data from the National Survey of Drug Use and Health (NSDUH), we conducted a series of logistic regressions examining associations between opioid misuse and a range of health risks, controlling for sociodemographic variables and survey year. RESULTS: Approximately 17% of those on probation or parole indicated past-year opioid misuse, a rate 4 times higher than in the general population. Compared to those on probation and parole who did not misuse opioids, it was associated with higher odds of other health risk behaviors and mental health problems. For example, the odds of marijuana and cocaine use were 4-6 times higher and the odds of substance use disorder were 10 times higher. Similarly, the odds of experiencing major depressive episodes and serious psychological distress were 2-3 times higher. CONCLUSIONS: Our findings reveal a markedly high risk for opioid misuse within this population along with associated risks for behavioral and mental health problems. The complex treatment needs of this population require greater policy attention and further research.

Trauma and Incarceration: A Latent Class Analysis of Lifetime Trauma Exposures for Individuals in Prison.

This paper aims to contribute to the knowledge base about the lives of individuals who experience incarceration in the U.S. in order to advance post-release intervention services. Research has shown that among the millions of Americans who cycle through prisons and jails each year, the majority are poor, in poor health, living in contexts of chronic violence, often with mental illness, and more than half are people of color. Of particular concern for this population are high rates of trauma exposure and PTSD, though the research in this area is underdeveloped, particularly for men. Using survey data gathered during a large (n = 1,516, 90% male) multi-state randomized control trial of a reentry intervention, this study used latent class analysis (LCA) to explore types and timing of trauma exposures across the life course. LCA has been found to be an effective statistical tool in intervention research for identifying high-risk groups and for informing the tailoring of interventions. This study found three latent classes: 1) Lifetime Interpersonal Polyvictimization, 2) Lifetime Environmental Exposures, and 3) Low Exposure. About one third of the sample fell within each class. Study findings indicate that not only should trauma-informed and trauma-specific interventions be the norm in reentry services, including for men, but that these interventions should target both individual and environmental factors.

Foster children in care due to parental incarceration: A national longitudinal study.

Using national child welfare data, we created a longitudinal data set (N = 142,143) to examine a subset of foster children (7%) who entered care due to parental incarceration (PI). Spanning FY 2005-2017, the dataset allowed us to compare children who entered care due to PI to children entering for other reasons. We found children of incarcerated parents were younger (median age of 4 vs. 6), more often White (47% vs. 42%), and less often Black (15% vs. 20%) when compared to other foster children. Parental use of alcohol (12% v. 6%) and drugs (42% v. 26%) were both more common among children who entered due to PI compared to those who entered for other reasons. Our understanding of this population is limited by inadequate data collection procedures that fail to account for societal changes created by mass incarceration. Our data indicate that investments in substance use treatment could decrease the number of children entering care.

In what kinds of communities do people on the sex offender registry live? An analysis of ten states.

This is the first large scale community-level study describing the characteristics of communities where Registered Sex Offenders (RSO's) are more likely to live. This study presents RSO residence data from ten states, combined with census data. Zip code characteristics (e.g., income, race/ethnicity, percent of population under 18) were then used in bivariate analyses and negative binomial regression analyses to determine which community factors predicted RSO residency. Lower median household income predicted higher rates of RSO's in nine of the ten states. These effects were large, with the rate of RSO's dropping about two percentage points per $1000 in increased median household income. Other community characteristics were found to have smaller effects on a state by state basis.

A Practical Framework for Considering the Use of Predictive Risk Modeling in Child Welfare.

Predictive risk modeling (PRM) is a new approach to data analysis that can be used to help identify risks of abuse and maltreatment among children. Several child welfare agencies have considered, piloted, or implemented PRM for this purpose. We discuss and analyze the application of PRM to child protection programs, elaborating on the various misgivings that arise from the application of predictive modeling to human behavior, and we present a framework to guide the application of PRM in child welfare systems. Our framework considers three core questions: (1) Is PRM more accurate than current practice? (2) Is PRM ethically equivalent or superior to current practice? and (3) Are necessary evaluative and implementation procedures established prior to, during, and following introduction of the PRM?

Innate immune genes synergize to predict increased risk of chronic disease in hepatitis C virus infection.

Hepatitis C is a common infection with significant morbidity and mortality, and only a minority of patients successfully clear the infection. Identification of factors that influence disease progression in HCV infection is difficult owing to the lack of well-defined patient cohorts. However, recent evidence supports a role for the innate immune system in virus clearance. In this study, we investigated innate immune genes for their contribution to disease progression in a unique cohort of well-controlled HCV-infected patients. The Irish cohort of HCV patients is uniquely homogenous; patients were infected with a single genotype of HCV from contaminated anti-D Ig. We genotyped 543 infected patients, including 247 patients who spontaneously resolved infection, for natural killer (NK) cell-associated killer cell Ig-like receptors (KIR) genes and the recently reported IL28B (IFNλ3) SNP. The NK cell gene KIR2DS3 was significantly increased in patients with chronic infection [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.25-2.90, P < 0.002]. The IL28B "T" allele was also significantly increased in chronically infected patients (OR 7.38, 95% CI 4.93-11.07, P < 10(-8)). The presence of both markers synergized to significantly increase the risk of chronic infection over either factor alone (OR 20.11, 95% CI 9.05-44.68, P < 10(-7)). In functional experiments, we found that IL28A significantly inhibited IFN-γ production by NK cells. Thus, we demonstrate a functional link between NK cells and type 3 IFN. Our findings may contribute to the development of a prognostic test for HCV and identify therapeutic strategies for the clinical management of HCV-infected patients.

The Mass Incarceration Trauma Framework: A Conceptual Model for Understanding Trauma among Individuals Who Experience Incarceration.

The Mass Incarceration Trauma (MIT) framework is a conceptual model for understanding the role of trauma in the lives of individuals who experience incarceration in the United States. This population faces poverty, violence, and discrimination across the life span. The MIT framework is guided by an ecological systems perspective, a foundational theoretical approach in social work that recognizes that effective assessment and intervention require an understanding of the complex contexts in which individuals live. The MIT framework presents the cumulative trauma exposures commonly faced by this population before, during, and after incarceration at the individual, social, environmental, and historical levels. Because traumatic stress undermines health and daily functioning, it is essential that interventions for this population address both the ongoing risk for trauma exposure and the consequences of multiple, repeated past exposures across ecological systems. It is to be hoped that a new and fundamental focus on the poverty, contexts of violence, and lifetime disadvantages experienced by those who cycle through prisons in the United States might reframe the question of how our society should prevent and respond to crime as well as respond to those swept into the criminal justice system.

IFNL cytokines do not modulate human or murine NK cell functions.

The interferon-lambda (IFNL) cytokines have been shown to be important in HCV infection with SNPs in the IFNL3 gene associated with both natural and treatment induced viral clearance. We have recently shown that rs1299860 (an IFNL3 associated SNP) and an NK cell gene, KIR2DS3, synergised to increase the odds of chronic infection in a homogenous cohort of Irish women infected with HCV. To characterise a biological basis for the genetic synergy, we investigated for any evidence that IFNL cytokines regulate NK cell functions. Using a range of functional responses, we did not find any evidence of NK cell activation by IFNL3, IFNL1 or IFNL2 cytokines. Similar results were found using human and murine NK cells. In addition, and in contrast to our preliminary study, we did not find any evidence that IFNL cytokines inhibited NK cell cytokine production; thus, the biological basis for the genetic synergy remains to be discovered.