The Carceral System’s Role in Opioid Misuse and Overdose Risk Among Black Men: A Qualitative Analysis

Overdose rates among Black men have increased fourfold since 2015. Several systemic factors contribute to Black men's opioid use outcomes, including the impact of the carceral system. Given the heightened risk of opioid overdose upon release from incarceration, there is a need to examine the structural impact of incarceration on opioid use among Black men. Thus, the current study examines the incarceration experiences of 20 Black men who use opioids to better understand how these experiences influence their drug use. The reflexive thematic analysis revealed five key themes: (1) Socialization of Carceral Systems Throughout Development, (2) Varied relationships of Opioids While Incarcerated, (3) Access to Treatment Programs/Resources While Incarcerated, (4) Cycle of Incarceration, Racism, and Illicit Opioid Use, and (5) No Implication. These themes and respective subthemes demonstrate the significant and pervasive impact of the carceral system on Black men's opioid use experiences and trajectories, for many shaping patterns of opioid use during incarceration and following release. Considerations for researchers and practitioners are provided based on the study findings.