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Relapse occurred in the context of poor social support, re-entry challenges and lack of financial resources.
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Attention to the psychosocial and practical needs of re-entry is necessary to reduce risk.
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Participants reported medical and mental-health problems combined with limited access to health care and medications.
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Re-entry services should include attention to meeting basic medical needs.
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Participants described ubiquitous exposure to drugs, alcohol, and drug trafficking in the environments to which they were released.
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Transitional housing should be away from neighborhoods with ubiquitous drug activity. Encourage avoidant behaviors and skills to avoid exposure.
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Perception of high risk of overdose after release from prison because of diminished tolerance.
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Educate inmates about lower drug tolerance at release and provide bystander naloxone training and distribution.
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Overdose perceived as a means of coping with unbearable stress and anxiety.
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Teach new coping mechanisms for the stress and anxiety that accompanies release.
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Relapse after release perceived as a coping mechanism for depression, anxiety, and frustration.
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Enhance coping skills and ensure medication continuity for mental-health conditions. Motivate inmates to seek and preserve healthy relationships for support. Connect inmates with religious/spiritual institutions and community-based organizations.
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Preventive factors included structured drug-treatment programs, spirituality/religion, community-based services, self-help programs, and family.
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Offer inmates structured treatment for substance use disorders after release, help them link to community-based services, encourage use of self-help programs, and support positive family roles and relationships.
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