Impact of opioid substitution therapy for Scotland's prisoners on drug-related deaths soon after prisoner release
Impact of opioid substitution therapy for Scotland's prisoners on drug-related deaths soon after prisoner release
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DOI：
10.1111/add.12969
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发表时间：
2015-10-01
期刊：
影响因子：
6
通讯作者：
Fraser, Andrew
中科院分区：
文献类型：
--
作者：
Bird, Sheila M.;Fischbacher, Colin M.;Fraser, Andrew
目的评估引入监狱阿片类药物替代疗法(OST)政策是否与监狱释放后14天内与毒品相关的死亡(DRD)减少有关。苏格兰囚犯数据库与死亡登记的设计链接，以比较(1996-2002)和(2003-07)基于监狱的OST之前和之后的时期。设置所有苏格兰监狱。参与者在1996年1月1日至2007年10月8日之间释放的人，在监禁至少14天后，在前一次合格释放后至少14周。测量在释放后12周内与药物相关死亡的风险；在以监狱为基础的OST之前(1996年至2002年)，305个DRD发生在80200个合格释放后的12周内，每1000个释放中有3.8个发生[95%可信区间=3.4-4.2]；其中175个(57%)发生在前14天。在引入以监狱为基础的OST后(2003年至2007年)，在70317名合格释放后的12周内发生了154起DRD，显著降低了每1000人释放2.2%的比率(95%CI=1.82.5)。然而，前14天发生的比例没有变化，无论是所有DRD(87：56%)还是与阿片类药物相关的DRD。结论在苏格兰引入基于监狱的阿片类药物替代疗法(OST)政策后，在释放后12周内与药物有关的死亡率下降了五分之二。然而，发生在前14天的死亡比例没有明显变化，这表明监狱中的OST并不能减少获释后的过早死亡。
AimTo assess whether the introduction of a prison-based opioid substitution therapy (OST) policy was associated with a reduction in drug-related deaths (DRD) within 14days after prison release.DesignLinkage of Scotland's prisoner database with death registrations to compare periods before (1996-2002) and after (2003-07) prison-based OST was introduced.SettingAll Scottish prisons.ParticipantsPeople released from prison between 1January 1996 and 8October 2007 following an imprisonment of at least 14days and at least 14weeks after the preceding qualifying release.MeasurementsRisk of DRD in the 12weeks following release; percentage of these DRDs which occurred during the first 14days.FindingsBefore prison-based OST (1996-2002), 305 DRDs occurred in the 12weeks after 80200 qualifying releases, 3.8 per 1000 releases [95% confidence interval (CI)=3.4-4.2]; of these, 175 (57%) occurred in the first 14days. After the introduction of prison-based OST (2003-07), 154 DRDs occurred in the 12weeks after 70317 qualifying releases, a significantly reduced rate of 2.2 per 1000 releases (95% CI=1.8-2.5). However, there was no change in the proportion which occurred in the first 14days, either for all DRDs (87: 56%) or for opioid-related DRDs.ConclusionsFollowing the introduction of a prison-based opioid substitution therapy (OST) policy in Scotland, the rate of drug-related deaths in the 12weeks following release fell by two-fifths. However, the proportion of deaths that occurred in the first 14days did not change appreciably, suggesting that in-prison OST does not reduce early deaths after release.