The criminal legal system (CLS) has become a crucial point of intervention for women at high risk of overdose, particularly as the number of incarcerated women continues to increase. In response to this growing concern, a study was conducted in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN) to examine the effectiveness of overdose education and naloxone distribution (OEND) procedures. The study involved 900 women who were incarcerated in nine Kentucky jails and were randomly selected, screened for opioid use disorder, and consented to participate in the study. These women were then followed for three months after their release from jail to track their use of naloxone and any overdose experiences. The study's findings highlight the urgent need for targeted prevention interventions to reduce overdose risk among women involved in the CLS. The results show that a significant proportion of the women in the study had a history of injection drug use and non-fatal overdoses prior to their incarceration. Specifically, 74.4% of the women reported lifetime injection, and 54.9% had a lifetime history of non-fatal overdose. Following their release from jail, approximately 70% of the women received a naloxone unit as part of the study, and 30 of them reported using it during the three-month follow-up period. Notably, about 4% of the sample experienced a non-fatal overdose during this time. These findings suggest that women who have been involved in the CLS are at high risk of overdose, particularly during the transition from incarceration to community re-entry. Therefore, targeted OEND efforts, such as naloxone distribution, are essential to reduce overdose risk and support the reintegration of these women into their communities. The study's results emphasize the importance of addressing the unique needs of women at highest risk of overdose and providing them with effective interventions to prevent overdose and promote their overall well-being. Link: https://pubmed.ncbi.nlm.nih.gov/40369292/