High risk of overdose death following release from prison: variations in mortality during a 15-year observation period
High risk of overdose death following release from prison: variations in mortality during a 15-year observation period
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DOI：
10.1111/add.13803
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发表时间：
2017-08-01
期刊：
影响因子：
6
通讯作者：
Clausen, Thomas
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文献类型：
--
作者：
Bukten, Anne;Stavseth, Marianne Riksheim;Clausen, Thomas
背景和目的从监狱释放后的时间涉及死亡率升高，特别是过量死亡。对从监狱释放以来的时间和释放时间的过量死亡率的变化没有进行充分的调查。我们的目的是估计和比较监狱释放后的时间间隔内的过量死亡率，并估计在日历时间内过量死亡率的影响。设计，设置，参与者，测量这项为期15年的队列研究包括所有从监狱释放的个体（n=91090（2000年1月1日至2014年12月31日）从挪威监狱登记处获得，与挪威死亡原因登记处（2000-14）相关联。在释放后的不同时间段（第1周、第2周、3- 4周和2- 6个月）和三个不同的释放时间间隔内检查全因和特定原因死亡率。我们计算了粗死亡率（CMR）每1000人年和估计发病率比（IRR）的泊松回归分析调整后的时间间隔，释放期间和监狱中度过的时间。FindingsOverdose死亡占85%（n=123）的所有死亡在第一周后释放（n=145），在释放后的2天内立即达到高峰。与第1周相比，第2周过量死亡的风险降低一半以上[IRR=0.43; 95%置信区间（CI）=0.31-0.59]，第3-4周降低至五分之一（IRR=0.22; 95% CI=0.16-0.31）。与2005-09年（IRR=0.53; 95% CI=0.43-0.65）和2010-14年（IRR=0.47; 95% CI=0.37-0.59）相比，2000-04年释放后前6个月内过量死亡的风险几乎高出两倍。过量死亡的风险是最高的那些被监禁了3- 12个月相比，那些被监禁了较短或较长的时间，累犯与过量死亡的风险。ConclusionsThere是一个升高的风险，从挪威监狱释放的个人之间的药物过量死亡，在第一周达到峰值。自2000- 2004年以来，这种风险有所降低，但与较短或较长时间相比，服刑3- 12个月的风险最大。
Background and AimsThe time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been investigated sufficiently. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time.Design, Setting, Participants, MeasurementsThis 15-year cohort study includes all individuals (n=91090) released from prison (1 January 2000 to 31 December 2014) obtained from the Norwegian prison registry, linked to the Norwegian Cause of Death Registry (2000-14). All-cause and cause-specific mortality were examined during different time-periods following release: first week, second week, 3-4weeks and 2-6months, and by three different time intervals of release. We calculated crude mortality rates (CMRs) per 1000 person-years and estimated incidence rate ratios (IRR) by Poisson regression analysis adjusting for time intervals after prison release, release periods and time spent in prison.FindingsOverdose deaths accounted for 85% (n=123) of all deaths during the first week following release (n=145), with a peak during the 2 days immediately following release. Compared with week 1, the risk of overdose death was more than halved during week 2 [IRR=0.43; 95% confidence interval (CI)=0.31-0.59] and reduced to one-fifth in weeks 3-4 (IRR=0.22; 95% CI=0.16-0.31). The risk of overdose mortality during the first 6months post-release was almost twofold higher in 2000-04 compared with 2005-09 (IRR=0.53; 95% CI=0.43-0.65) and 2010-14 (IRR=0.47; 95% CI=0.37-0.59). The risk of overdose death was highest for those incarcerated for 3-12months compared with those who were incarcerated for shorter or longer periods, and recidivism was associated with risk of overdose death.ConclusionsThere is an elevated risk of death from drug overdose among individuals released from Norwegian prisons, peaking in the first week. The risk has reduced since 2000-04, but is greatest for those serving 3-12months compared with shorter or longer periods.