Engaging and Motivating to Prevent Overdose Among Women via Effective Reentry: EMPOWER A Women-Centered Behavioral...

Women with substance use disorders (SUDs) released from incarceration face a markedly elevated risk of fatal overdose during the first 2 weeks post-release compared with women with SUDs in the community. Prior research estimates that individuals leaving incarceration may be more than 100 times more likely to die from overdose during this period than the general population. This article describes a gender-responsive behavioral health reentry model, Engaging and Motivating to Prevent Overdose among Women via Effective Reentry (EMPOWER), implemented statewide in North Carolina. Among 359 self-referred women with SUDs, the program reported zero fatal overdoses during the 2-week post-release period. EMPOWER builds upon Jenna's Project: Preventing Overdose and Improving Recovery Outcomes for Women Leaving Incarcerated Settings During Pregnancy and Postpartum Periods, which served 132 perinatal women and reported zero fatal opioid overdoses at 6 months post-release. EMPOWER expanded the population to include women aged 18-44 years with a history of illicit substance use across three state prisons, regardless of pregnancy status. These findings suggest that evidence-based behavioral health interventions delivered during early reentry may reduce fatal overdose risk and demonstrate preliminary acceptability and feasibility. To our knowledge, this is among the first manuscripts to examine overdose outcomes during the critical 2-week post-release period among justice-involved women in North Carolina.