Nearly half of people using opioids in rural areas were recently incarcerated, study shows

By Ben Botkin (Oregon Capital Chronicle)
Nov. 11, 2023 6:59 p.m.

Oregon Health & Science University author of national study says jails have an opportunity to treat drug addiction

Almost half of people in rural areas who use illicit drugs were in prison or jail in the last six months, according to a new national study.

The study surveyed nearly 3,000 people in rural areas spanning 10 states, including Oregon, who use illicit drugs including fentanyl, heroin and other opioids. Within the group, 42% were in prison or jail within the past six months.


The study suggests the nation — and Oregon — should do more to reach and treat people for drug addiction while they are incarcerated and in custody. The findings come as Oregon is in the midst of an opioid addiction crisis and hundreds of Oregonians are dying every year from overdoses.

“You have a reachable time in jails, and most jails are not providing this kind of addiction care,” said the study’s lead author, Dr. Dan Hoover, an assistant professor of medicine at Oregon Health & Science University’s School of Medicine. “In a broader sense, our correctional institutions have a mandate to rehabilitate people who have entered the system — and treating addiction is a huge part of that.”

The guidelines advise against using opioids as the first-line therapy for mild to moderate pain.

FILE - Opioid pills are being poured into a bottle. A national study shows nearly half of people in rural areas who use illicit drugs often were incarcerated recently, including in Oregon.

Kristian Foden-Vencil / OPB

Researchers at Oregon Health & Science University and from nine other states — Illinois, Wisconsin, North Carolina, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire and Vermont — participated in the study, which was published Thursday in the journal JAMA Network Open. The study relied upon data from the Rural Opioid Initiative, a research consortium.

In Oregon, much of the attention on drug addiction is through the lens of Measure 110, which voters passed in 2020 to decriminalize possession of small amounts of hard drugs and put cannabis revenue toward addiction treatment and services. Since then, concerns have mounted about public drug use and rising drug overdoses. Gov. Tina Kotek and Oregon lawmakers say Oregon’s addiction crisis will be front and center during the 2024 session as the state looks for ways to help addicts get treatment, keep public areas safe and prosecute drug dealers.

Related: Jackson County officials grapple with a growing overdose crisis

The study’s participants were surveyed between January 2018 and March 2020, before Measure 110 passed.

And the study’s findings offer lessons for Oregon, Hoover said.


“There is an incredibly large mismatch really between where the medical need in jails is for substance use disorder care, and then how available that is and how funded that is,” Hoover said. “That’s something that we really need to do something about.”

Hoover said Oregon’s system could take several steps to address the problem, including prioritizing funding and partnering with providers, with a focus on getting treatment inside facilities.

“We need the leadership inside the correction system to say that that’s a high priority,” he said.

Related: Only 1 in 5 people with opioid addiction get the medications to treat it, study finds

More than half of about 12,000 inmates in Oregon’s state prisons have an addiction or drug use problem, according to a 2022 state report of the state’s addiction treatment services and gaps in coverage. But only about 9% of inmates who need treatment receive it while in custody, according to legislative testimony the Oregon Department of Corrections submitted in March when lawmakers considered a bill to expand access to treatment. That bill died.

County officials, Hoover said, also have a role to play and can direct funding, including opioid settlement funds, toward their jails.

Incarceration without treatment does not serve people, Hoover said.

Related: ‘It’s crazy out there’: The reasons behind Oregon’s deepening drug crisis

When incarcerated people have withdrawal symptoms without treatment, they will be more vulnerable to begin using drugs and reoffend when they are released, Hoover said.

Drugs continue to be a challenge as incarcerated people with addiction problems enter jails on other charges, like property crimes.

“Substance use disorder is still in our jails,” Hoover said. “We did not come anywhere close to eliminating the need for substance use disorder treatment in our jails. It’s just a persistent need that will be there. And we definitely want to respond the best way we can.”

This story was originally published by the Oregon Capital Chronicle. Oregon Capital Chronicle is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Oregon Capital Chronicle maintains editorial independence. Contact Editor Lynne Terry for questions: Follow Oregon Capital Chronicle on Facebook and X.