A Prospective Study of Injection Drug Use and Jail Readmission in Two Western North Carolina Counties

Abstract

Background Injection drug use among people admitted to rural jails has significant implications for both infectious disease transmission and incarceration patterns. This study examines the relationship between injection drug use, jail readmission, and detention duration to inform interventions designed specifically for this understudied correctional setting. Methods The Comprehensive Addiction and Psychological Evaluation-5 (CAAPE-5) was administered to a random sample of adults admitted to two county detention centers in Western North Carolina. Data regarding readmission and the length of detention were obtained for the 12-month study period. Results Participants included 420 adults, aged 18–66 years. Nearly three-quarters (70.9%) met criteria for at least one substance use disorder (SUD) and almost half (45.7%) met criteria for multiple SUDs. Approximately half (45.2%) reported injecting drugs, with the majority (71.6%) reporting injecting methamphetamine, followed by 51.1% who injected opioids. People who injected drugs were 1.83 times more likely (95% CI = 1.17–2.87) than those who did not inject to be admitted on multiple occasions and also spent a significantly longer amount of time detained (IRR = 1.34, 95% CI = 1.02–1.77) during the 12-month follow-up period. Limitations The study was limited to jails in two counties and injection-related factors may vary from other facilities. Conclusions The association between drug injection and longer detention periods presents an opportunity to engage people with infectious disease screening and substance use services in jails. Connection to stable primary and behavioral health care after release is a high priority in enhancing community health.