Non-fatal drug overdose after release from prison: A prospective data linkage study
Non-fatal drug overdose after release from prison: A prospective data linkage study
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DOI：
10.1016/j.drugalcdep.2019.107707
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Kinner, Stuart A.
中科院分区：
文献类型：
--
作者：
Keen, Claire;Young, Jesse T.;Kinner, Stuart A.
背景：从监狱释放的成年人健康状况不佳和可预防死亡的风险增加，包括过量用药。非致死性药物过量（NFOD）是未来药物过量的有力预测因素，并与相当大的发病率相关。本研究的目的是确定NFOD的发病率，预测因素和临床特征释放后从prison.Methods：我们使用释放前的随机对照试验在2008-2010年收集的访谈数据，并连接人的水平，全州范围内的救护车，急诊科，和医院的记录，从一个有代表性的样本1307名成年人被监禁在澳大利亚昆士兰州。计算了从监狱释放后NFOD的发生率。多变量Andersen-Gill模型用于确定NFOD的人口统计学、健康、社会和刑事司法预测因素。NFOD的粗发病率（IR）为47.6（95%CI 41.1-55.0）/1000人-年，在出狱后的前14天最高（IR = 296/1000人-年，95%CI 206-426）。在多变量分析中，从监狱释放后的NFOD与最近的物质使用障碍（SUD）史，精神疾病和SUD的双重诊断，注射毒品使用的终身史，NFOD的终身史，释放后被分配苯二氮卓类药物，较短的指数监禁，和低感知的社会支持呈正相关。NFOD的风险是较低的人与高风险的酒精使用，而inclinated.Conclusions：从监狱释放的成年人是在高风险的非致命性过量，特别是在释放后的头14天。在监狱和社区之间提供协调一致的过渡性护理可能对减少吸毒过量的风险至关重要。
Background: Adults released from prison are at increased risk of poor health outcomes and preventable mortality, including from overdose. Non-fatal overdose (NFOD) is a strong predictor of future overdose and associated with considerable morbidity. This study aims to the determine the incidence, predictors and clinical characteristics of NFOD following release from prison.Methods: We used pre-release interview data collected for a randomised controlled trial in 2008-2010, and linked person-level, state-wide ambulance, emergency department, and hospital records, from a representative sample of 1307 adults incarcerated in Queensland, Australia. The incidence of NFOD following release from prison was calculated. A multivariate Andersen-Gill model was used to identify demographic, health, social, and criminal justice predictors of NFOD.Results: The crude incidence rate (IR) of NFOD was 47.6 (95%CI 41.1-55.0) per 1000 person-years and was highest in the first 14 days after release from prison (IR = 296 per 1000 person-years, 95%CI 206-426). In multivariate analyses, NFOD after release from prison was positively associated with a recent history of substance use disorder (SUD), dual diagnosis of mental illness and SUD, lifetime history of injecting drug use, lifetime history of NFOD, being dispensed benzodiazepines after release, a shorter index incarceration, and low perceived social support. The risk of NFOD was lower for people with high-risk alcohol use and while incarcerated.Conclusions: Adults released from prison are at high risk of non-fatal overdose, particularly in the first 14 days after release. Providing coordinated transitional care between prison and the community is likely critical to reduce the risk of overdose.