Mortality due to opioid overdose found most often in prisoners post-release

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1. Researchers found that mortality due to opioid overdose was the most common cause of mortality among prisoners post-release and prisoners are 10.33 times more likely to overdose compared to control population 

2. Female prisoners have higher rates of opioid overdose than males

Evidence Rating Level: 2 (Good)

Study Rundown: This study used information from the National Death Index to investigate mortality data in a population (n=76,208) of incarcerated individuals following their release from prison. The study was conducted across multiple prison facilities in Washington state from 1999 to 2009. Analysis revealed that individuals who had been incarcerated were 10.33 (95% CI: 8.61-11.10) times more likely to die from a pharmaceutical opioid overdose compared to control data from the CDC. Researchers also found that the overdose mortality rate in women was significantly higher than in men. Generalizability of this study may be limited by region as data was only analyzed on prisoners in the state of Washington. Furthermore, researchers were unable to determine whether pharmaceutical opioids were prescribed or obtained illicitly. However, the findings in this study still provide valuable data for policy makers and public health officials to better understand the unique health challenges of the incarcerated population.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Release from prison – a high risk of death for former inmates

In-Depth [retrospective analysis]: Within the population of 76,208 individuals released from prison during the time of the study, there were a total of 2,462 deaths in the population (3.2%). Within this group the most common cause of mortality was unintentional death (n=828) including both overdose (n=558) and car accident (n=183). The drugs used to overdose were: heroine (n=123), methadone (n=176), and pharmaceutical opioids including hydrocodone and oxycodone (n=259). Researchers also presented rates of mortality in terms of 100,000 person-years to compare rates in men and women because there is a significantly larger male (n=63,979) sample size compared to female (n=12,229). Of all categories of drug overdose, females were found to have significantly (p<0.001) higher rates of mortality (236 deaths/100,000 person-years; 95% CI: 194-277) compared with men (154 deaths/100,000 person-years; 95% CI: 140-169).

By Jordan Anderson and Andrew Bishara

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