Substance use disorders and avoidable mortality after prison

Worldwide, more than 30 million people spend time in prison every year.1 The USA incarcerates 25 % of these people and one in 31 Americans is currently under correctional control, either in jail, prison, or on probation or parole.2 Most prisoners will eventually be released, and the 2 weeks after release have been shown to be associated with a substantial increase in mortality, especially from overdose.3 Substance use disorders are highly prevalent among incarcerated populations, with more than half of prisoners in some countries being imprisoned for drug-related convictions.4 In the USA, 85 % of people in prisons or jails are substance involved, with 1·5 million individuals meeting DSM criteria for a substance use disorder and an additional 458 000 either with a history of substance use, under the influence at the time of arrest, or convicted of a crime committed to obtain money to buy drugs.5 Addiction is a treatable disease and decades of scientific evidence support the efficacy of treatment to improve clinical outcomes, save lives, and reduce societal costs. Treatment for opioid use disorder during incarceration with agonists such as buprenorphine or methadone has been shown to reduce recidivism, improve treatment retention, reduce illicit drug use