ArticleAmerican journal of preventive medicine2022
Legal System Involvement and Opioid-Related Overdose Mortality in U.S. Department of Veterans Affairs Patients.
Article in American journal of preventive medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- Article
- Receipt of medications for opioid use disorders among veterans by race/ethnicity and legal involvement: an observational study of electronic health records.Health & justice · 2025Article
- Changes in legal referrals to specialty substance use disorder treatment from 2015-2019.Health & justice · 2024Article
- Influences of the criminal justice system on use of medications for opioid use disorder: a qualitative study.BMC global and public health · 2024Article
- Comorbidities, healthcare use, and contact with healthcare transition services in older veterans after incarceration.Journal of the American Geriatrics Society · 2024Article
- Health Conditions and Treatment Utilization Among Older Male Veterans Incarcerated in Prisons.Journal of general internal medicine · 2024Observational
- Scoping review of military veterans involved in the criminal legal system and their health and healthcare: 5-year update and map to the Veterans-Sequential Intercept Model.Health & justice · 2024Article
- How legal problems are conceptualized and measured in healthcare settings: a systematic review.Health & justice · 2023Article
- High Risk of Substance Use Disorder-Related Outcomes in Veterans Released from Correctional Facilities in Mid to Late Life.Journal of general internal medicine · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
introductionOpioid-related overdose risks are elevated after incarceration. The rates of opioid-related overdose mortality have risen in recent years, including among Veterans Health Administration patients. To inform Veteran overdose prevention, this study evaluates whether opioid-related overdose risks differ for Veterans Health Administration patients with versus those without indicators of legal system involvement.
methodsThis retrospective national cohort study, conducted in 2019-2021, used Veterans Health Administration electronic health records and death certificate data from the Department of Veterans Affairs/Department of Defense Mortality Data Repository to examine opioid-related overdose mortality from January 1, 2013 through December 31, 2017. The cohort included 5,390,902 Veterans with Veterans Health Administration inpatient or outpatient encounters in 2012 who were alive as of January 1, 2013, of whom 32,284 (0.60%) patients had legal system involvement in 2012, indicated by Veterans Justice Programs outpatient encounters. Cox proportional hazards regression models assessed the associations between legal involvement and risk of opioid-related overdose mortality.
resultsThere were 4,670 opioid-related overdose deaths, including 295 (6.31%) among legal-involved Veterans. Veterans with legal involvement had a higher opioid-related overdose mortality rate per 100,000 person-years (191.22, 95% CI=169.40, 213.04 vs 17.76, 95% CI=17.23, 18.29, p<0.001) and an elevated risk of opioid-related overdose mortality (adjusted hazard ratio=1.38, 95% CI=1.22, 1.57, p<0.001) compared with those without.
conclusionsAmong Veterans receiving Veterans Health Administration care in 2012, documented legal system involvement was associated with an increased risk of opioid-related overdose mortality. Targeting overdose education and naloxone distribution programs and integrating opioid overdose prevention efforts into mental health care may reduce opioid overdose deaths among Veterans with legal involvement.
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