SynthesisThe Lancet. Public health2024
Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis.
Synthesis in The Lancet. Public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The global epidemiology of injecting drug use, HIV, viral hepatitis and tuberculosis among people who are incarcerated: a multistage systematic review.The International journal on drug policy · 2026Pooled it
- Drug use among people in prison: A global review of epidemiology, harms and interventions.Addiction (Abingdon, England) · 2026Pooled it
- Prescribing methadone in prison predicts linkage to HIV care after release from prison: A randomized and patient preference trial.The International journal on drug policy · 2025Trial
- EuroHePP: The European Toolkit to Strengthen National Responses for the Elimination of Viral Hepatitis in Prisons.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Health, Social and Recidivism Outcomes Among People Who Have Been Incarcerated in New South Wales, Australia: Study Protocol and Cohort Profile for the Prison Outcomes STudy (POST).Drug and alcohol review · 2026Article
- Effects of a Relapse Prevention Program on motivation, relapse, and stress management in correctional settings.Substance abuse treatment, prevention, and policy · 2026Article
- Mortality and return to custody of individuals with a history of drug use one year post-release from the New South Wales custodial system.Scientific reports · 2025Article
- A self-assessment of opioid use disorder services at a Pacific Northwest County jail.Substance abuse treatment, prevention, and policy · 2025Article
- Article
- Feasibility of implementing viral hepatitis services into a correctional service facility in Cape Town, South Africa.The International journal on drug policy · 2025Article
- Improving implementation of needle and syringe programmes to expand, scale up, and sustain evidence-based prevention interventions for HIV and hepatitis C in prisons.The Lancet. Public health · 2025Article
- Meeting the mental health needs of women in Irish prisons: A qualitative multi-stakeholder perspective to inform healthcare practice.PloS one · 2025Article
- The burden of drug overdose deaths among correctional populations: implications for interventions.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
10 authors.
Funding
Abstract
backgroundMortality, suicide, self-harm, and substance use are elevated among people who are incarcerated. There is a wide range of heterogeneous interventions aimed at reducing these harms in this population. Previous reviews have focused on specific interventions or limited their findings to drug use and recidivism and have not explored interventions delivered after release from prison. Our aim is to examine the effect of interventions delivered to people who use drugs during incarceration or after release from incarceration, on a wide range of outcomes.
methodsIn this systematic review and meta-analysis, we searched Embase, MEDLINE, and PsycINFO databases up until Sept 12, 2023 for studies published from Jan 1, 1980 onwards. All studies evaluating the effectiveness of any intervention on drug use, recidivism outcomes, sexual or injecting risk behaviours, or mortality among people who use psychoactive drugs and who were currently or recently incarcerated were included. Studies without a comparator or measuring only alcohol use were excluded. Data extracted from each study included demographic characteristics, interventions, and comparisons. Pooled odds ratios and risk ratios were calculated using random-effects meta-analyses.
findingsWe identified 126 eligible studies (47 randomised controlled trials and 79 observational studies) encompassing 18 interventions; receiving opioid-agonist treatment (OAT) in prison reduced the risk of death in prison (one study; hazard ratio 0·25; 95% CI 0·13-0·48), whereas receiving OAT in the first 4 weeks following release reduced risk of death in the community (two studies; relative risk 0·24; 95% CI 0·15-0·37). Therapeutic community interventions reduced re-arrest at 6-12 months (six studies; odds ratio [OR] 0·72; 95% CI 0·55-0·95) and reincarceration at 24 months (two studies; OR 0·66; 95% CI 0·48-0·96). There was scarce evidence that OAT and syringe service provision are effective in reducing injecting risk behaviours and needle and syringe sharing.
interpretationThere are effective interventions to reduce mortality and recidivism for people who use drugs who have been incarcerated. Nonetheless, there are also substantial gaps in the research examining the effect of interventions on risk behaviours and mortality during incarceration and a need for randomised designs examining outcomes for people who use drugs after release.
fundingAustralian National Health and Medical Research Council.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.