Staying out of prison after release

​AURORA, Colo. – In the words of one ex-prisoner, “…The hardest thing is not going back to the lifestyle that got me put in prison.” Prison inmates frequently have a strong history of drug use and misuse, especially during the time prior to incarceration when drugs often are the driving force behind the offense itself. But new research shows that ex-offenders struggle to remain drug-free after their release from prison as well, and identifies factors that they say can help them succeed in this struggle. The research was authored by Ingrid Binswanger, MD, MPH, an assistant professor from the University of Colorado Division of General Internal Medicine, School of Medicine, and her colleagues from Kaiser Permanente Colorado. 

Interviews with former inmates within two months from their release date show that they themselves recognize that returning to former living environments (former friends and an easy access to drugs) is a strong trigger for drug use and overdose. The interviews focused on the ex-inmates’ experience of drug and alcohol use after release, their perception of risk of overdose, and their experience of overdose. 
Binswanger, a Robert Wood Johnson Foundation Physician Faculty Scholar who led the study, summarized, “These interviews show that former inmates with a history of drug use, and criminal behavior related to their drug use, are often released back into environments with significant social and economic challenges, readily available drugs and little support. A consequence of this is a high risk of intentional and unintentional overdose. Structured treatment, a gradual transition back into the community, and coping strategies could help. They also need access to ‘protective’ factors, as well as improved resources, to reduce the main triggers for relapse.” 
Four main points came across clearly from these interviews. The former inmates felt that a return to drug use was due to poor social support, or that it provided a way to cope with inadequate economic resources and health problems. Secondly, drugs were readily available in their living environment and were a constant temptation. Studies have shown that there is a high risk of drug-related death after release from prison, and these ex-prisoners reported that while overdose was seen as a “way out” in the face of overwhelming difficulties, accidental overdose due to decreased drug tolerance was also common. Finally, the ex-inmates identified ”protective” factors – including structured drug treatment programs, spirituality, self-help groups, and family – that they felt could strengthen them against relapse. 
The study is published in Addiction Science & Clinical Practice
About the RWJF Physician Faculty Scholars program
The Robert Wood Johnson Foundation Physician Faculty Scholars program strengthens the leadership and academic productivity of junior medical school faculty dedicated to improving health and health care. Under the program, scholars receive funds to support a research project, receive national and local mentorship, and work with other talented scholars. For more information, visit
Faculty at the University of Colorado School of Medicine work to advance science and improve care. These faculty members include physicians, educators and scientists at University of Colorado Hospital, Children’s Hospital Colorado, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. Degrees offered by the CU Denver School of Medicine include doctor of medicine, doctor of physical therapy, and masters of physician assistant studies. The School is located on the University of Colorado’s Anschutz Medical Campus, one of four campuses in the University of Colorado system. For additional news and information, please visit our online newsroom. 

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