Women leaving Kentucky prisons are at extreme risk of overdose in the weeks after release, and a new federally funded study aims to find out whether a trauma-informed intervention can change that.

The Department of Health and Human Services has awarded a $444,826 grant to develop and test a program specifically designed for women coming out of prison-based substance use treatment. The effort addresses a stark and often overlooked trend: overdose deaths among American women have risen nearly 500% over the past two decades, a rate far outpacing that of men.

Women involved in the criminal justice system face compounding risks. Many carry histories of trauma, violence, and substance use that standard addiction treatment programs weren't built to address. The period immediately after prison release is particularly dangerous, when tolerance drops but the pull of old environments and unresolved trauma remains strong.

The new program, called TBRI-WRA (Trust-Based Relational Intervention for Women's Reentry), combines group sessions inside prison with recovery support that continues after release. Researchers will first refine the approach through focus groups with administrators, practitioners, and women with firsthand experience of the criminal justice system, then run a small pilot with eight women in Kentucky.

If the pilot goes well, the study expands to a full trial across four prison sites, enrolling 264 women and comparing the new program against standard in-prison substance use treatment. Researchers will track drug use and trauma symptoms for six months after each participant is released.

The work builds on a growing body of research recognizing that effective addiction treatment for women requires addressing violence and victimization alongside substance use. Similar thinking has driven trauma-focused addiction research elsewhere, including work at the Medical University of South Carolina testing integrated treatment for teens with both addiction and trauma.

Results from the full trial will determine whether the program is ready for broader adoption in prison systems across the country.