Incarcerated Travis County residents at drastically higher risk of accidental overdose death

People who have been incarcerated in Travis County die of accidental overdoses at drastically higher rates than the overall population, according to new data.

On Tuesday, the Travis County Commissioners Court held a news conference in conjunction with the Travis County Sheriff’s Office and county public health experts to address a new report released by the county’s Justice & Public Safety data and research team.

Travis County Judge Andy Brown directed the team to work with the Travis County Medical Examiner’s Office to determine if there is an overlap between accidental drug overdose deaths following a period of incarceration. The goal was to use the data to inform a public health response to the overdose crisis.

The analysis found that 89 of the 471 people who died of an accidental drug overdose in 2022 – or about one in five – had been in jail at least once within 12 months of their death. Twenty-seven percent were booked into the jail with a flag indicating they’d received mental health services during a previous stay.

“In Travis County, just like nationally, being homeless, having an unmet mental health need or being incarcerated are key indicators to whether you are at a higher risk of accidental overdose death,” Brown said.

Statistically, that means a person in Travis County is eight times more likely to die of a drug overdose within the first 12 months of leaving jail compared to the rest of the county. The data shows individuals were at the greatest risk of overdose death in the first 30 days of leaving jail.

Of the 89 people who experienced a jail stay in 2021 or 2022 prior to an accidental overdose death, 39 percent were experiencing homelessness at the time of their death.

“All of these are preventable deaths, and one of the ways we can help stop the cycle is by helping divert people with mental illness or substance use disorder, who don’t belong in jail, but rather access to support services,” Brown said.

He said the county also can ensure that individuals who leave jail are connected to peer support specialists that are informed by harm reduction practices. That includes organizations such as CommUnityCare, Central Health and other local providers.

“Whether they’re in jail for a day, an hour, two years – we want to make sure there is a warm handoff to care,” Brown said. “Mental health care, substance use, medically assisted treatment.”

Nicholas Yagoda, chief medical officer at CommUnityCare, praised the county’s work on the issue. He said public health officials, community groups, law enforcement and all levels of government can collaborate to assemble evidence-based harm reduction tools to implement in the community.

“We could devise broadly conceived, community-based harm reduction responses that uphold the dignity of our vulnerable neighbors who use drugs,” Yagoda said.

Travis County Medical Director/Health Authority Desmar Walkes cited work the county is doing to coordinate with its partners in the city of Austin and within the service provider community.

“We are also working to improve our data sharing so that in the end, we can do a warm handoff, and ensure the data that will help clinicians provide the care they need to for our citizens who are suffering and dying (is there),” she said.

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