Correctional Facility Opioid Harm Reduction: A Medication Safety and Opioid Risk Screening Program Pilot

The Opioid and Naloxone Education (ONE) Program expanded to correctional facilities in North Dakota to address the impact of opioid misuse among incarcerated individuals. This pilot aimed to evaluate the feasibility and outcomes of implementing comprehensive opioid risk screening, education, and harm reduction interventions in correctional settings. Among 168 individuals who were screened, 65.5% were at risk for opioid-related harm. Unsafe medication storage and disposal were common, and 13% reported diversion behaviors. Nearly 90% accepted naloxone, lockboxes, and disposal tools, demonstrating initial engagement with harm reduction modalities. Seventeen percent have previously received medication for opioid use disorder, and 19% expressed interest in initiating treatment. The findings of this pilot suggest implementing opioid risk screening and harm reduction education within correctional settings is feasible and associated with high engagement. The ONE Program may provide a structured approach to identifying risk and supporting linkage to harm reduction resources.