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The effects of offering treatment with injectable naltrexone during reentry on long-term mortality
Journal article   Open access   Peer reviewed

The effects of offering treatment with injectable naltrexone during reentry on long-term mortality

Jordan M. Hyatt and C. Clare Strange
Journal of experimental criminology, Forthcoming
26 May 2026
DOI: https://doi.org/10.1007/s11292-026-09757-1
url
https://doi.org/10.1007/s11292-026-09757-1View
Published, Version of Record (VoR) Open

Abstract

Background Injectable naltrexone (XR-NTX) is an FDA-approved opioid agonist treatment (OAT) for the prevention of relapse to opioid abuse. While there is a growing consensus about its efficacy in community settings, less is known about the effect on justice-involved people, particularly in the time immediately after incarceration. The unique needs of this population warrant additional inquiry, especially regarding the prevention of mortality, as they are at an increased risk of death during the reentry period. Methods The current study follows a wait-list randomized control design and was conducted within a large state-level correctional system located in the Eastern United States. Eligible individuals could receive no-cost XR-NTX before their release from incarceration or six months after release. Analyses followed an intention-to-treat (ITT) framework. Results A policy of providing injectable naltrexone did not significantly increase or decrease mortality among people leaving prison, though lower mortality rates and longer time to failure were observed among those people starting OAT treatment while incarcerated. Conclusions The evidence on XR-NTX remains mixed concerning justice-related outcomes (e.g., recidivism), as well as mortality among people leaving prison. The elevated risk- and needs-profile of this population, considered in conjunction with the existing evidence base on MAT, suggests that this remains an important avenue for future research.

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