Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015
Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015
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DOI：
10.2105/ajph.2018.304514
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发表时间：
2018-09-01
影响因子：
12.7
通讯作者：
Marshall, Stephen W.
中科院分区：
文献类型：
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作者：
Ranapurwala, Shabbar I.;Shanahan, Meghan E.;Marshall, Stephen W.
目标。目的比较前北卡罗来纳州(NC)囚犯和北卡罗来纳州(NC)居民阿片类药物过量死亡(OOD)发生率的差异，评价与服刑后OOD相关的因素。我们将囚犯释放数据与NC死亡记录联系起来，计算OOD标准化死亡率以比较前囚犯和NC居民，并计算危险比以确定到OOD时间的预测因素。在2000年至2015年期间释放的229 274名前囚犯中，有1329人在获释后死于过量服药。服刑2周、1年和完全随访时，服刑前服刑人员的OOD危险度分别是普通服刑人员的40倍(95%可信区间=30，51)、11倍(95%CI=9.5，12)和8.3倍(95%CI=7.8，8.7)，海洛因过量死亡风险分别是普通服刑人员的74倍(95%CI=43,106)、18倍(95%CI=15，21)和14倍(95%CI=13，16)。服刑前服刑人员中，服刑前2周内、年龄26~50岁、男性、白人、服刑2次以上、曾接受过狱中精神卫生和药物滥用治疗的服刑人员是OOD风险最大的服刑人员。前囚犯非常容易受到阿片类药物的影响，需要采取紧急预防措施。
Objectives. To examine differences in rates of opioid overdose death (OOD) between former North Carolina (NC) inmates and NC residents and evaluate factors associated with postrelease OOD.Methods. We linked NC inmate release data to NC death records, calculated OOD standardized mortality ratios to compare former inmates with NC residents, and calculated hazard ratios to identify predictors of time to OOD.Results. Of the 229 274 former inmates released during 2000 to 2015, 1329 died from OOD after release. At 2-weeks, 1-year, and complete follow-up after release, the respective OOD risk among former inmates was 40 (95% confidence interval [CI] = 30, 51), 11 (95% CI = 9.5, 12), and 8.3 (95% CI = 7.8, 8.7) times as high as general NC residents; the corresponding heroin overdose death risk among former inmates was 74 (95% CI = 43, 106), 18 (95% CI = 15, 21), and 14 (95% CI = 13, 16) times as high as general NC residents, respectively. Former inmates at greatest OOD risk were those within the first 2 weeks after release, aged 26 to 50 years, male, White, with more than 2 previous prison terms, and who received in-prison mental health and substance abuse treatment.Conclusions. Former inmates are highly vulnerable to opioids and need urgent prevention measures.