Opioid Overdose Mortality Among Former North Carolina Inmates: 2000–2015

Ranapurwala, Shabbar I.; Shanahan, Meghan; Alexandridis, Apostolos A.; Proescholdbell, Scott; Naumann, Rebecca B.; Edwards, Daniel; Marshall, Stephen W.

doi:10.2105/ajph.2018.304514

Cited by 152 publications

(86 citation statements)

References 23 publications

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“…Third, the Consortium includes cohorts with a degree of heterogeneity and this is likely to have impacted the observed mortality estimates. For example, participants in several cohorts all have as inclusion criteria a history of opioid dependence [22,24,47] and/or a diagnosis of HIV [28,47,48], contributing to an increased risk of mortality. The impact of this cohort heterogeneity will be explored by conducting sensitivity analyses which exclude selected cohorts.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

Borschmann¹,

Tibble²,

Spittal³

et al. 2020

IJPDS

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IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. ObjectivesTo comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. MethodsWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. ResultsThe combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. ConclusionsThe consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. Key wordsMortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.

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Section: Strengths and Weaknessesmentioning

confidence: 99%

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

Borschmann¹,

Tibble²,

Spittal³

et al. 2020

IJPDS

View full text Add to dashboard Cite

show abstract

“…A recent study in North Carolina showed that the risk for OOD among inmates within two-weeks post-release from prison was 40 times higher than that of the general population; heroin carried an even greater risk, with recently released individuals being 74 times more likely than the general population to die from a heroin overdose (Ranapurwala et al, 2018). Furthermore, those receiving mental health services while incarcerated had almost twice the risk of OOD during the study period compared to those who did not receive mental health services (Ranapurwala et al, 2018). The increased vulnerability of this population demonstrates the importance of connection to communitybased services, specifically substance use treatment, prior to reentry into the community.…”

mentioning

confidence: 99%

Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative

Hanna

Kubiak

Pasman

et al. 2020

Journal of Substance Abuse Treatment

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“…Similarly, the absence of prescription records corresponding to medication assisted treatment (MAT) for OUD is a reflection of treatment practices and not the underlying prevalence. The need for MAT in prison and at release was highlighted by a recent North Carolina study which found that in the first two weeks following prison release, there was a 74 and 40 times greater risk of death from heroin and opioid overdose, respectively, as compared to the risks among those in the general population [24]. Although the need for OUD treatment during and following incarceration has gained significant attention in North Carolina and across the country, like other chronic health conditions, the health care resources for people released from prison are inadequate.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Chronic Health Conditions Among Adults Released From the North Carolina Prison System, 2015-2016

Rosen

Thomas

Kavee³

et al. 2019

North Carolina Medical Journal

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background In the United States each year nearly 570,000 people return from state prisons to the community. Prevalence data of chronic health problems for this population are lacking, impeding planning of health care programs to serve people with chronic conditions who are re-entering the community. method We used medication dispensing records as a proxy for diagnoses in assessing the prevalence of 10 major and 20 substituent health conditions among incarcerated people released from the North Carolina state prison system from July 2015 through June 2016. results Among 20,585 released people, 13% were female; 50% were black; 43% were white; and 4% were aged 55 years or older. Thirtythree percent had ≥ 1 condition and 13% had two or more. The prevalence of chronic health conditions was the following: psychiatric, 15%; cardiovascular, 15%; neurologic, 7%; pulmonary, 6%; diabetes mellitus, 3%; and infectious, 3%. Seventy-one percent of those aged 55 years or older had a chronic medical condition. Among those with a psychiatric condition, 56% had another chronic illness. limitations We could not identify unmedicated health conditions; medications prescribed across multiple disease categories were excluded from our analysis. conclusion In North Carolina, at least one in three people released from the state prison system had a chronic health condition, and among those with psychiatric conditions, most had comorbid medical disease. Coordination of health care after release from incarceration is essential to avoid preventable complications and unnecessary utilization of acute care services. Greater eligibility for Medicaid is needed to scale up transition programs for this population.

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Opioid Overdose Mortality Among Former North Carolina Inmates: 2000–2015

Abstract: Former inmates are highly vulnerable to opioids and need urgent prevention measures.

Cited by 152 publications

References 23 publications

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis

Evaluating the implementation of a prisoner re-entry initiative for individuals with opioid use and mental health disorders: Application of the consolidated framework for implementation research in a cross-system initiative

Prevalence of Chronic Health Conditions Among Adults Released From the North Carolina Prison System, 2015-2016

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