The Impact of Policy Changes on Heroin and Nonmedical Prescription Opioid Use Among an Incarcerated Population in Kentucky, 2008 to 2016

In response to the opioid epidemic, there have been several national- and state-level policies enacted. Consideration of how criminal justice–involved individuals are affected by such policies has received limited attention, despite disproportionately higher use among this population. Bivariate statistics examined yearly trends, and logistic regressions examined demographic correlates of nonmedical prescription opioid and heroin use among Kentucky inmates over an 8-year time span of important national and local policy changes ( N = 34,542). Results indicate that among incarcerated individuals, prior use of heroin increased 204% from 2008 to 2016, with increases possibly linked to key policy changes associated with OxyContin reformulation and state implementation of a prescription drug monitoring program. The current incarcerated population had more severe use patterns when considering general population research. Consideration of criminal justice–involved populations is crucial to understanding and treating the opioid epidemic.