PriSUD-Nordic—Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study

Bukten, Anne; Lokdam, Nicoline Toresen; Skjærvø, Ingeborg; Ugelvik, Thomas; Gabrhelík, Roman; Skarðhamar, Torbjørn; Lund, Ingunn Olea; Havnes, Ingrid Amalia; Rognli, Eline Borger; Chang, Zheng; Fazel, Seena; Friestad, Christine; Hesse, Morten; Lothe, Johan; Ploeg, Gerhard; Dirkzwager, Anja; Clausen, Thomas; Tjagvad, Christian; Stavseth, Marianne Riksheim

doi:10.2196/35182

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…This study from Norway (see Supplementary Information , available as Supplementary data at IJE online) is based on the PriSUD-project 40 using data from the Norwegian Prison Release Study (nPRIS), 41 which is based on data from the Norwegian prison registry 42 , 43 linked to various national registries. All women holding a personal identification number (PIN), serving a prison sentence or pre-trial detention between 1 January 2000 and 31 December 2019 ( n = 11 313) were included.…”

Section: Methodsmentioning

confidence: 99%

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study

Svendsen,

Bukten,

Skardhamar

et al. 2024

International Journal of Epidemiology

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Background Women carry a substantial burden of psychiatric, somatic and lifestyle-related morbidity in the prison context. By describing causes of death and estimating the risk and burden of mortality compared with the general population, this study investigates how mortality operates in this highly marginalized and under-researched population. Methods In this registry-based study of all women incarcerated in Norwegian prisons from 2000 to 2019 (N = 11 313), we calculated crude mortality rates, years of lost life and, by using mortality in age-matched women from the general population as a reference, age-standardized mortality ratios and years of lost life rates. Results Over a mean follow-up time of 10.7 years, at a median age of 50 years, 9% of the population had died (n = 1005). Most deaths (80%) were premature deaths from an avoidable cause. Drug-induced causes and deaths from major non-communicable diseases (NCDs) were most frequent (both 32%). Compared with women in the general population, women with a history of incarceration were more likely to die from any cause. Trends in annual age-standardized years of lost life rates suggest that the mortality burden associated with major NCDs has gradually replaced drug-induced causes. Conclusions Women with a history of incarceration die at a greater rate than their peers and largely from avoidable causes. The profile of causes contributing to the substantial burden of mortality placed on this population has changed over time and has important implications for future efforts to reduce morbidity and the risk of premature death following release from prison.

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Section: Methodsmentioning

confidence: 99%

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study

Svendsen,

Bukten,

Skardhamar

et al. 2024

International Journal of Epidemiology

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“…For this study, the main research question and analysis plan have been pre-registered and made publicly available [16].…”

Section: Discussionmentioning

confidence: 99%

“…This study was based upon multi‐national data from the PriSUD‐Nordic study [16], including three national cohorts of people aged 19 years and older, imprisoned in Norway (2010–19), Denmark (2010–18) and Sweden (2010–13). Data for 2019 were not available for analysis in Denmark and data for 2014–19 were not available for analysis in Sweden.…”

Section: Methodsmentioning

confidence: 99%

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The prevalence of substance use disorders among people in Norwegian, Danish and Swedish prisons: A multi‐national cohort study, 2010–19

Bukten,

Virtanen,

Hesse

et al. 2024

Addiction

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AimsWe estimated the prevalence of substance use disorders (SUDs) in the Norwegian, Danish and Swedish prison populations and compared the prevalence of SUDs in the national prison populations with country‐specific general population prevalence rates.DesignA multi‐national cohort study using data from the National Prison Registries linked to the National Patient Registries in Norway, Denmark and Sweden.Setting and participantsWe used data from the PriSUD‐Nordic study, including national prison populations aged 19 years and older in Norway (2010–19), Denmark (2010–18) and Sweden (2010–13). A total of 119 507 Individuals (108 971 men and 10 536 women) contributing to 191 507 incarcerations were included in the study (Norway: 45432 men; 5429 women, Denmark: 42 162 men; 3370 women, Sweden: 21 377 men; 1737 women).MeasurementWe calculated a study prevalence and prevalence at entry to prison for all types of SUDs before imprisonment each consecutive year of observation in each prison population. We also extracted country‐specific 1‐year prevalence rates from the Global Burden of Diseases database to calculate comparative national prevalence ratios.FindingsThe study prevalence of any SUD was approximately 40% [Norway: 44.0%, 95% confidence interval (CI) = 43.6–44.5%; Denmark: 39.9%, CI = 39.5–40.4%; Sweden: 39.1%, CI = 38.4–39.7%] in all three countries. Women had a significantly higher study prevalence of any SUD compared with men (Norway: 55.8 versus 42.6%, P < 0.001; Denmark 43.1 versus 39.7%, P = 0.004; Sweden: 51.7 versus 38.0%, P < 0.001). Prevalence estimates were higher for SUDs among people in prison than in the general population. We observed an increasing proportion of people with SUDs entering prison in Norway (P = 0.003), while the proportion was more stable in Denmark and Sweden.ConclusionsSubstance use disorders (SUDs) appear to be highly prevalent among the Scandinavian prison populations compared with the general population, especially among women. In Norway, there was a relative increase in SUDs from 2010 to 2019.

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“…This study is a part of the PriSUD-Nordic project [ 23 ], and included people imprisoned in Norway in 2010–2019, Denmark in 2010–2018, and Sweden in 2010–2013. The observation periods for all countries are referred to as the study period throughout this paper.…”

Section: Methodsmentioning

confidence: 99%

The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010–2019: a multi-national register study

Bukten,

Virtanen,

Hesse

et al. 2024

BMC Psychiatry

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Background Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. Methods The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010–2019), Denmark (2011–2018), and Sweden (2010–2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. Results The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. Conclusions While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.

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PriSUD-Nordic—Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study

Cited by 8 publications

References 28 publications

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study

The prevalence of substance use disorders among people in Norwegian, Danish and Swedish prisons: A multi‐national cohort study, 2010–19

The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010–2019: a multi-national register study

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