Mortality among Danish drug users released from prison

Abstract

To determine the mortality of drug users after release from prison in Denmark, a cohort of drug users was identified from two national registers during 1996 Á2001: the drug treatment register (T) and the register of viral hepatitis (H). Incarcerations were extracted from the national penal register, vital status from the civil register, and causes of death from the death certificate register and the police register of drug-related deaths. We identified 15,885 drug users (T: 15,735, H: 896), 62% of the estimated drug-using population in Denmark. There were 1000 observed deaths, of which 51% were classified as overdose deaths. Mortality in the treatment cohort was 2.4/100 person years (py) (95% C.I. 2.2 Á2.5/100 py) compared to the general population expectation of 0.2/100 py. Within the first 2 weeks after release from prison, 26 deaths were observed among 6019 released drug users corresponding to 13/100 py (95% CI 8 Á19/100 py). Overdose deaths accounted for 24/26 deaths (92%) in the first two weeks compared to 121/179 (68%) hereafter (p B/0.001). We conclude that drug users released from prison are at high risk of overdose death. We suggest that methadone treatment should be evaluated as a way to decrease mortality after release from prison.

Suicide risk among recently released prisoners in New South Wales, Australia

“…This corroborates previous post‐release studies from other countries, which have focused on death from overdose and found the risk of death in the first 2 weeks to be seven to 11 times higher than in other periods at liberty 6 , 11 . ‐ 15 Suicide has received far less attention in previous studies, but we found it poses a risk of death in men four times higher in the first 2 weeks after release than in the period beyond 6 months after release.…”

Relative Mortality among Criminals in Norway and the Relation to Drug and Alcohol Related Offenses

“…The first model shows that the risk of death for offenders relative to the control group (non-offenders) is 2.1 times higher for males and 2.5 times higher for females. These estimates lie in a similar range to differences between those with high and low educational or income levels [26], [43] but are lower than estimates for prisoners [12], [44]. The next model shows the results for the offender population split into those with and without an unconditional custodial sentence.…”

“…A study of Norwegians convicted for drug use (N = 1112) find that they have a significantly higher mortality risk than the overall population [15]. The risk of overdose among opiate users, particularly after a period of non-use such as a prison term, exacerbates the risk of death [2], [12], [15]–[17]. Ex-prisoners’ elevated risk of death has also been found to be directly or indirectly related to alcohol addiction, including violent death, liver disease and liver cancer [18].…”

“…Norwegians convicts, including those who are driving under the influence of alcohol, tend to have relatively low education, income, and parental status, particularly for women [25], and low socio-economic status tend to relate to higher mortality [26]. Studies have found that prisoners have a relatively high prevalence of hepatitis B/C virus, HIV/AIDS, tuberculosis and diabetes [5], [6], [12], [16], [18], [25], [27]–[29].…”

Longitudinal Effects of LAAM and Methadone Maintenance on Heroin Addict Behavior

“…[25][26][27] Although immediate entry into treatment would ameliorate this mortality, it is difficult to determine the number of lives saved or the prolongation of life attributable to the benefits of LAAM and MM. Within medicine, all drugs have the potential for adverse reactions.…”