New Data Suggests Mass Incarceration Contributed to the Opioid Crisis

Opioid addict arrested.

The American incarceration system earns a fair amount of criticism among Americans and foreigners alike. And there are some good reasons for that.

For one thing, the U.S. incarcerates its citizens at a rate exceeding all other countries in the world. About 2.3 million Americans are locked up in prisons, according to the Prison Policy Initiative. In a nation of about 329 million people, that means one in every 143 Americans is in jail. Also, the U.S. incarceration system is almost entirely privatized, and it earns a fair degree of criticism for that. The argument is that, under private ownership, companies profit off the imprisonment of human beings, with the financial incentive being naturally to incarcerate more people to make more money.

Another factor is the overwhelming presence of drug-related criminal sentences leading to incarceration. About 1 in 5 incarcerated individuals are in jail for a nonviolent drug offense. That usually appears in the form of an addict getting caught using drugs and then going to jail for it. About 45,000 Americans are sent to prison every day for nonviolent drug offenses.

But while all of those issues are serious and indicative of a need for prison reform, they are not the subject of today’s discussion. This article intends to shed light on new research published in the Lancet and reported on in U.S. News. The findings give us yet another reason to cease mass incarceration of nonviolent drug offenders. According to the Lancet publication, counties that suffer from increasing incarceration rates also have increasing rates of drug overdoses.

Drawing Parallels between Incarceration and Overdose

According to a direct quote from the Lancet research paper, “Extensive evidence has linked incarceration to various factors that are associated with drug overdoses, including stigma, unemployment, family disruption, and neighborhood decline. Our findings suggest a strong association between the rise in incarceration rates and mortality rates from drug use disorders, over and above the potential effects of low household income and other important confounders.”

The data quoted above was gathered by researchers at the University of Massachusetts. The information is available on open access at the Lancet and can be read in full on the Lancet website without a subscription or membership fee. It is quite an eye-opening read, and it begs the question as to whether or not mass incarceration is the correct approach for nonviolent drug offenders. If imprisonment is meant to rehabilitate drug offenders but instead results in an increased chance of overdose, doesn’t that ultimately defeat the purpose?

“In communities with high incarceration rates, it’s making their lives much worse, and making them much more likely to use drugs dangerously.…”
Paramedics handling overdose.

Gaby Galvin, a staff writer for U.S. News, picked up the Lancet research and reported on it in the July 3, 2019 issue of U.S. News. Professor Lawrence King, a co-author of the Lancet study, was available for comment in the U.S. News article. He said that “In communities with high incarceration rates, it’s making their lives much worse, and making them much more likely to use drugs dangerously. It’s not as big a factor as economic decline, but it’s a very big substantial factor.”

What the professor is saying is that individuals who have served time in a jail or prison are more likely to overdose on drugs than those who have not. And in counties where a significant percentage of the residents have served time, this always leads to a marked upsurge in overdoses in those counties.

The researchers went on to examine the opposite end of the spectrum. If counties and neighborhoods with high incarceration rates among their residents were also associated with higher than average overdose rates, what about counties with low incarceration rates?

When the researchers examined the counties with the lowest incarceration rates in the U.S., the overdose rates in those counties were 54% lower than the overdose rates in counties with the highest incarceration rates.

Drug use, drinking, and addiction can happen to anyone. Addiction does not discriminate. No one is 100% safe from the risk of drug addiction merely because of a particular background, demographic, or birthright. However, drug use and addiction are more likely to touch down in impoverished communities. We always thought that living in poverty, joblessness, and other factors led to overdoses. Now, thanks to the new research, we can add rising incarceration rates as another factor which is directly connected to overdoses.

Professor King commented again on the importance of addressing the nation’s soaring incarceration frenzy. “We can’t just think about the supply of drugs, but about why people use drugs. The contextual factors are super important—and that isn’t just economic decline. The U.S. has the highest incarceration rate in the world, and that has major public health impacts. Incarcerating people for drug use actually is extremely counterproductive, if what you want to do is reduce harms from drug use. Incarcerating people for drug use actually just increases the damage from drugs.”

What Can We Do About It?

We have to change our approach to drug offenders to direct them to treatment as opposed to incarceration. That does not mean we should legalize or accept drug use—quite the opposite. Instead we should implement diversion programs which direct drug offenders to residential rehab centers that focus on helping them with their drug habits. Jail is not a drug treatment center.

In addition to the prison system worsening the risk of overdoses, there is also the struggle for getting a job after serving a prison sentence. And then there’s other bad habits one may have picked up in jail. And the stigma that goes along with being an ex-con. The list goes on.

A better approach would be to maintain our strict refusal to allow drug use as “accepted behavior” but to change our approach to the users. We need to recognize that drug use is not a criminal inclination, rather a crippling affliction of the mind and body. Let’s commit to diverting addicts to residential drug rehab, not jail. Doing so will quite literally save lives.


Reviewed by Claire Pinelli ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.