Formerly incarcerated patient care in student-run clinics: substance use patterns and opportunities for intervention

Incarcerated patients have high rates of substance misuse and are at an increased likelihood of mortality within the first six months post-release. Student-Run Free Clinics (SRFCs) are common amongst medical schools in the United States. The purpose of the study was to evaluate and understand the carceral history of patients served by New Orleans SRFCs in order to provide better care for these patients. The data in this study was obtained from the REDcap surveys administered to patients of the SRFCs (n = 2,035) from 2/19/17 to 7/9/23. Individuals who filled out information regarding incarceration history were included in the study (n = 969). Information regarding incarceration history and substance use were self-reported. Chi-square tests and P-values (significance at p < 0.05) were obtained via Microsoft Excel. At least 34% of total individuals seen in the Tulane Student Clinics from 2/19/17 to 7/9/23 self-reported as being justice-impacted (n = 2035). When comparing justice-impacted to non-justice-impacted patients in Tulane’s SRFCs, formerly incarcerated patients had a significantly higher rate of tobacco use. When considering substance use within the last 30 days, tobacco, illicit drug use, and alcohol use were significantly higher in formerly incarcerated patients than non-formerly incarcerated patients. Notably, unhealthy alcohol use within the last 30 days was significantly lower among formerly incarcerated patients than non-formerly incarcerated patients. Interest in smoking cessation was significantly higher among formerly incarcerated patients than non-formerly incarcerated patients. SRFCs provide a unique and valuable opportunity for healthcare systems to engage with formerly incarcerated individuals in the local community. SRFCs should leverage this opportunity to provide much needed resources and individualized care to formerly incarcerated individuals, while also addressing gaps in healthcare formerly incarcerated individuals may have experienced. Given the higher prevalence of substance use and interest in smoking cessation among formerly incarcerated patients, it is crucial for SRFC staff to be well-informed about community resources, support services, and evidence-based treatment approaches when caring for these individuals. The documented challenges related to substance use within the formerly incarcerated community highlight the potential for SRFCs to serve as effective sites for intervention and referral services.