Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men.

BACKGROUND: The Centers for Disease Control and Prevention has deemed nonmedical opioid use (NMOU) an epidemic. Population-based survey data indicate high rates of NMOU among Caucasians, however, these estimates exclude incarcerated samples and may underestimate use among criminal justice-involved African Americans. Despite opioid-associated risks of co-occurring mental illness and mortality, to our knowledge, this is the first study to examine NMOU and mental health among a sample of African American men receiving corrections-based substance use disorder (SUD) treatment in jail, prison, or the community.

METHOD: We conducted a cross-sectional study examining trends and mental health correlates of NMOU during the year prior to each participant's incarceration, across five cohorts of African American men (N = 4021) enrolled in corrections-based SUD treatment between the years, 2010 and 2014. A series of chi-square, ANOVAs, correlations, and logistic regression models were conducted.

RESULTS: Over 20% of our sample reported NMOU during the year prior to incarceration. On average, participants were 36-years-old, earned 13 years of education, and were generally unemployed, prior to incarceration. We found a statistically significant positive linear trend between NMOU prior to incarceration and cohort year. The final stepwise multivariate regression model was significant and revealed, older age was associated with lower odds of NMOU. More years of education and frequent mental health symptoms were associated with significantly increased odds of NMOU.

DISCUSSION: Our findings are unique in that extant literature has primarily described NMOU as a 'White suburban' problem. Culturally-adapted behavioral interventions and medication assisted therapies are discussed.